| NPI | 1518658798 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA MARIE FIELDS Owner/Operator 810-610-5480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2023-05-17 |
| Last Update Date | 2023-07-17 |