| NPI | 1801404272 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MALLORY BEARDSLEY Lpc 989-239-0870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2020-07-21 |
| Last Update Date | 2025-03-13 |