| NPI | 1285901058 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTOR MANZON Owner 269-348-0956 |
| Organization Subpart ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: MI 6801059772) |
| Additional Taxonomies | 103TC1900X Psychologist Counseling (Licence: MI 6301009199) |
| Enumeration Date | 2011-11-22 |
| Last Update Date | 2015-03-06 |