| NPI | 1912469115 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KANDICE MOSS Owner 248-893-7308 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 225600000X Dance Therapist | |
| Enumeration Date | 2019-04-05 |
| Last Update Date | 2019-04-05 |