| NPI | 1053897041 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY BETH HOUPT Credentialing 517-676-9788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801092806) |
| Enumeration Date | 2018-07-13 |
| Last Update Date | 2018-08-03 |