| NPI | 1841726809 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN A DUCKWORTH Clinical Psychologist 616-795-0298 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301016570) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2017-08-03 |