| NPI | 1497375380 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORY JOSEPH VEDIN Licensed Masters Social Worker/Owne 906-828-5118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2020-04-21 |
| Last Update Date | 2020-04-21 |