| NPI | 1336479138 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN L. GAUTHIER Clinical Social Worker 616-308-6423 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MI 6801080903) |
| Enumeration Date | 2009-12-30 |
| Last Update Date | 2009-12-30 |