| NPI | 1407252232 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS JAY OVERLY Social Worker 616-988-9049 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI L260765) |
| Enumeration Date | 2014-11-05 |
| Last Update Date | 2014-11-05 |