| NPI | 1053578179 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY L WIDENBAUM Clinical Therapist 248-568-9680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MI 6801066237) |
| Enumeration Date | 2008-05-16 |
| Last Update Date | 2013-08-26 |