| NPI | 1780079210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISAAC GORDON WATTS Owner 616-818-6637 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401009315) |
| Enumeration Date | 2015-04-01 |
| Last Update Date | 2024-08-16 |