| NPI | 1841419264 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE AUBREY RUNYON Clinician 248-355-3977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801085894) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2007-07-18 |