| NPI | 1649711789 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAKULA BROWN Administrator 313-974-0667 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 1041C0700X Social Worker, Clinical | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2017-03-08 |
| Last Update Date | 2023-07-08 |