| NPI | 1750068078 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA LYNN RICHARD Therapist 810-341-3822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2023-06-28 |
| Last Update Date | 2023-12-19 |