| NPI | 1447983010 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA MIDDLETON Credentialing 989-321-8918 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2022-07-01 |
| Last Update Date | 2023-07-07 |