| NPI | 1972053809 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALE WILLIAM EICHENBERG Professional Counselor 517-539-2518 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401011293) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: MI 6401011293) |
| Enumeration Date | 2016-10-04 |
| Last Update Date | 2016-10-04 |