NPI | 1699342543 |
---|---|
Entity Type | Organization |
Authorized Contact | SANDRA BATES Owner 269-993-0112 |
Organization Subpart ? | No |
Primary Taxonomy | 101YM0800X Counselor Mental Health |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
101YP2500X Counselor Professional | |
101YS0200X Counselor School | |
103T00000X Psychologist | |
103TA0400X Psychologist Addiction (Substance Use Disorder) | |
103TB0200X Psychologist Cognitive & Behavioral | |
103TC0700X Psychologist Clinical | |
103TC2200X Psychologist Clinical Child & Adolescent | |
103TF0000X Psychologist Family | |
103TP2701X Psychologist Group Psychotherapy | |
1041C0700X Social Worker Clinical | |
106H00000X Marriage & Family Therapist | |
261QM0850X Clinic/Center Adult Mental Health | |
Enumeration Date | 2021-06-09 |
Last Update Date | 2021-06-24 |