| NPI | 1821352121 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEILA KAE KILGORE Licensed Professional Counselor 517-315-1367 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401009781) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MI 6401009781) |
| 101YM0800X Counselor, Mental Health (Licence: MI 6401009781) | |
| 101YS0200X Counselor, School (Licence: MI CC-XVW450025540) | |
| Enumeration Date | 2012-07-02 |
| Last Update Date | 2012-07-02 |