| NPI | 1689229700 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY GRUBER Lpc 810-373-2053 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2019-08-06 |
| Last Update Date | 2019-08-06 |