| NPI | 1699466896 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY M TRIEU Owner 269-248-1006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103T00000X Psychologist | |
| Enumeration Date | 2023-05-17 |
| Last Update Date | 2026-05-22 |