| NPI | 1053866095 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE A TRUDELL Owner 989-574-5122 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801087718) |
| Enumeration Date | 2016-08-19 |
| Last Update Date | 2016-08-19 |