| NPI | 1255780979 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAYLE WITHAM Social Work 616-477-3404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801085993) |
| Enumeration Date | 2016-06-03 |
| Last Update Date | 2016-06-03 |