| NPI | 1063998474 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONSTANCE GWYNN Owner 248-893-7345 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801087813) |
| Enumeration Date | 2018-07-18 |
| Last Update Date | 2018-07-18 |