| NPI | 1720473382 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN NICHOLSON-MUTH Provider 734-276-2806 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801088873) |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2015-03-31 |