| NPI | 1639621857 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE D. OTTENBREIT Clinical Social Worker 313-575-6297 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI MSW-6801007603) |
| Enumeration Date | 2016-11-04 |
| Last Update Date | 2016-12-05 |