| NPI | 1689965329 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN J HEINEMAN President 269-345-7101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301013201) |
| Enumeration Date | 2011-04-28 |
| Last Update Date | 2011-04-28 |