| NPI | 1780733881 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY KAY WISDORF-HOUTKOOPER Licensed Psychologist 269-979-3881 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MI 6301009191) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2020-08-22 |