| NPI | 1750948220 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC J DYKSTRA Owner/Licensed Psychologist 616-667-9551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities | |
| Enumeration Date | 2019-05-21 |
| Last Update Date | 2023-03-21 |