| NPI | 1952731192 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN J DAVIS Counselor/Supervisor 616-214-8690 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6401013745) |
| Enumeration Date | 2013-11-26 |
| Last Update Date | 2013-11-26 |