| NPI | 1306217864 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEAN KLOSKA Owner/Therapist 1989-975-8039 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801077986) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI C-01973) |
| Enumeration Date | 2015-10-09 |
| Last Update Date | 2015-11-10 |