| NPI | 1790247716 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY BETH HOUPT Credentialing 517-676-9797 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2024-05-21 |