| NPI | 1760982722 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANCES S WATERS Clinical Social Worker 906-226-2777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MI 6801019797) |
| Enumeration Date | 2018-02-16 |
| Last Update Date | 2018-02-16 |