| NPI | 1922652783 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN WATERSTRADT Therapist/Owner 231-903-8538 |
| Organization Subpart ? | No |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2019-07-30 |
| Last Update Date | 2019-07-30 |