| NPI | 1578923769 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY BETH BOTTS Member 616-893-4519 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC05583000) |
| Enumeration Date | 2016-03-01 |
| Last Update Date | 2016-03-01 |