Provider First Line Business Practice Location Address:
212 KENT ST STE 5
Provider Second Line Business Practice Location Address:
CHILD AND FAMILY WELLNESS COUNSELING CTR
Provider Business Practice Location Address City Name:
PORTLAND
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48875
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
517-647-4600
Provider Business Practice Location Address Fax Number:
517-647-4600
Provider Enumeration Date:
03/10/2006