| NPI | 1578923892 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMERA LEGALO Credentialing 989-494-9057 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801095650) |
| Enumeration Date | 2016-02-29 |
| Last Update Date | 2025-12-18 |