| NPI | 1770859001 |
|---|---|
| Doing Business As | FENTON WELLNESS |
| Entity Type | Organization |
| Authorized Contact | JENNIFER FLACK President 810-309-9355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301014240) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MI 6401006094) |
| 104100000X Social Worker (Licence: MI 6801006671) | |
| Enumeration Date | 2012-03-30 |
| Last Update Date | 2012-03-30 |