| NPI | 1699272948 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY NEWBERG Medical Insurance Specilist 616-914-9730 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2018-04-11 |
| Last Update Date | 2025-05-05 |