| NPI | 1710222971 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY MARQUEE Psychologist/Administrator 616-443-8968 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MI 4301078556) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301013480) |
| Enumeration Date | 2012-11-29 |
| Last Update Date | 2012-11-29 |