| NPI | 1033424874 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKAYLA TANNER Owner 248-645-5960 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801077738) |
| Enumeration Date | 2010-08-17 |
| Last Update Date | 2016-04-28 |