| NPI | 1821147638 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARJORIE A SOPER Therapist 810-579-5757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801063883) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2008-04-22 |