NPI | 1972041648 |
---|---|
Entity Type | Organization |
Authorized Contact | MARY BETH HOUPT Credentialing 517-676-9788 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301016014) |
Enumeration Date | 2017-02-02 |
Last Update Date | 2021-05-27 |