| NPI | 1699725127 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM SWISHER Billing 616-942-8060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2012-03-26 |