| NPI | 1265951602 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARYBETH HOUPT Credentialing 517-676-9788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801091840) |
| Enumeration Date | 2017-09-18 |
| Last Update Date | 2017-09-18 |