| NPI | 1639707714 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW TAROCKOFF Member/Owner 248-410-1559 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 104100000X Social Worker |
| 1041C0700X Social Worker, Clinical | |
| 251S00000X | |
| Enumeration Date | 2020-04-01 |
| Last Update Date | 2024-08-08 |