| NPI | 1821516311 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | KIMBERLY MANRIQUE Licensed Professional Counselor/Own 231-709-3177  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401013605)  | 
| Enumeration Date | 2017-09-05 | 
| Last Update Date | 2022-01-11 |