| NPI | 1013378850 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN MARIE WOOD Director 269-808-0160 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801096207) |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2016-03-07 |
| Last Update Date | 2019-02-28 |