| NPI | 1457568784 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL BOUDRIE Co Owner 7434-770-7573 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801035097) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2015-01-13 |