| NPI | 1053621029 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTORIA THERESA TYLENDA-WONG Sole Proprietor 248-341-0710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801082431) |
| Enumeration Date | 2010-10-08 |
| Last Update Date | 2010-10-08 |