| NPI | 1306079884 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA ANN SHAMIE Member 248-605-5578 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801067946) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 204538) |
| Enumeration Date | 2009-08-31 |
| Last Update Date | 2010-02-16 |