| NPI | 1548667397 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY BETH HOUPT Credentialing 517-676-9788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MI 6801093841) |
| Enumeration Date | 2014-11-21 |
| Last Update Date | 2022-08-11 |