| NPI | 1316255516 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY RENEE ANTON Clinical Social Worker 734-788-8307 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801092555) |
| Enumeration Date | 2010-09-22 |
| Last Update Date | 2011-02-22 |