| NPI | 1770014227 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA ANNE BLOOM Owner 313-590-4740 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801092345) |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2017-03-27 |