| NPI | 1942689708 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAN RADLEY Owner 616-935-7606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301014390) |
| Additional Taxonomies | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2015-05-27 |
| Last Update Date | 2021-08-03 |