| NPI | 1316456684 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CECILIA SHARP Biller 517-920-4602 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MI 6801019125) |
| Enumeration Date | 2017-09-29 |
| Last Update Date | 2017-09-29 |