| NPI | 1790477180 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA MARIE PORTER Owner 810-293-5063 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2023-05-23 |
| Last Update Date | 2023-08-28 |