| NPI | 1164634929 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IDA KOGAN Owner Social Worker 248-539-0238 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801074428) |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2020-08-22 |