| NPI | 1467850131 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAJUAN S GIBSON Counselor/Authorized Official 810-210-7558 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2014-12-12 |
| Last Update Date | 2014-12-12 |