| NPI | 1770940884 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE P CUSHING Licensed Professional Counselor 248-680-0796 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: MI 6401005517) |
| Enumeration Date | 2016-01-20 |
| Last Update Date | 2016-01-20 |