| NPI | 1992292338 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY BETH HOUPT Credentialing 517-676-9788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: MI 6301009891) |
| Enumeration Date | 2018-04-20 |
| Last Update Date | 2022-03-24 |