| NPI | 1073099784 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY BETH HOUPT Credentialing 517-676-9788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801089687) |
| Enumeration Date | 2018-07-16 |
| Last Update Date | 2018-09-06 |