| NPI | 1790159093 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIKKI RENEE GARDNER Owner 734-678-5869 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OH #E3755) |
| Enumeration Date | 2015-11-24 |
| Last Update Date | 2023-12-20 |