| NPI | 1922763994 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH WATHEN Owner 989-397-2256 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2021-11-04 |
| Last Update Date | 2021-11-04 |