| NPI | 1508203472 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER ZOUTENDYK Provider 231-947-0511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801005145) |
| Enumeration Date | 2013-05-31 |
| Last Update Date | 2013-05-31 |