| NPI | 1699254730 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY BETH HOUPT Credentialing 517-676-9797 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: MI 6401011578) |
| Enumeration Date | 2018-08-09 |
| Last Update Date | 2023-10-29 |