| NPI | 1790284644 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARYBETH HOUPT Credentialing 517-676-9788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MI 4101006668) |
| Enumeration Date | 2018-02-06 |
| Last Update Date | 2018-02-06 |