| NPI | 1619604535 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE SUE SIERADZKI Social Worker/Provider 231-286-9172 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2022-08-02 |
| Last Update Date | 2024-07-09 |