Individual
GREGORY OUTLAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
QMHP
Contact information
Practice address
960 M 60 E, CASSOPOLIS, MI 49031-9339
(269) 445-2451
Mailing address
63357 CROOKED CREEK RD, CASSOPOLIS, MI 49031-9304
(574) 520-9044
(269) 445-3836
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/23/2014
Last updated
09/23/2014
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