| NPI | 1295125144 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE L MOODY Owner 517-515-4114 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801090018) |
| Enumeration Date | 2015-01-30 |
| Last Update Date | 2022-04-14 |