| NPI | 1841972742 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATIE TIBBLES Therapist 734-732-6295 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health |
| Enumeration Date | 2023-08-01 |
| Last Update Date | 2023-08-02 |