| NPI | 1770110470 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAIL KIACZ Owner 810-691-1114 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2020-03-24 |
| Last Update Date | 2020-06-25 |