| NPI | 1114301751 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIANEE C TAIT Social Worker 313-600-7167 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801081621) |
| Enumeration Date | 2015-07-14 |
| Last Update Date | 2015-07-14 |