| NPI | 1659883379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI ANN BUSH President/Owner 734-646-1505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801096561) |
| Enumeration Date | 2017-11-03 |
| Last Update Date | 2017-11-03 |