| NPI | 1558909119 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTEN LYNN HARRIS Licensed Master Social Worker 269-350-4677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2019-12-13 |
| Last Update Date | 2019-12-13 |