| NPI | 1790226413 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM KOOISTRA Clinical Psychologist 616-638-7557 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301007943) |
| Enumeration Date | 2017-03-14 |
| Last Update Date | 2017-03-14 |