| NPI | 1578717245 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA PETERSON Office Manager 517-347-4645 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801065439) |
| Enumeration Date | 2008-11-07 |
| Last Update Date | 2019-07-05 |