| NPI | 1255221339 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELYNDA SHAVONNE GREEN Licensed Clinical Social Worker 313-461-8601 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2025-07-08 |
| Last Update Date | 2025-07-08 |