| NPI | 1912494592 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY BETH HOUPT Credentialing 517-676-9788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: MI 6301009423) |
| Enumeration Date | 2018-04-18 |
| Last Update Date | 2019-07-30 |