| NPI | 1144702572 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONSTANCE BAAB Owner 231-360-0699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801082009) |
| Enumeration Date | 2018-09-01 |
| Last Update Date | 2018-09-01 |