| NPI | 1790398121 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL YOUNG Owner 616-862-5603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| 104100000X Social Worker | |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2020-08-25 |
| Last Update Date | 2020-08-25 |