| NPI | 1508382367 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA LOPEZ Owner 517-243-9738 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801088838) |
| Enumeration Date | 2017-08-14 |
| Last Update Date | 2018-03-17 |