| NPI | 1699151845 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARYBETH HOUPT Credentialing 517-676-9898 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401013683) |
| Enumeration Date | 2015-08-10 |
| Last Update Date | 2015-08-10 |