| NPI | 1619433521 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA LEE DAVARN Clinical Director 517-881-9867 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2019-02-15 |
| Last Update Date | 2023-08-15 |