| NPI | 1851712798 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHY S GALLEGOS Billing Manager 517-483-2461 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801092069) |
| Enumeration Date | 2013-12-19 |
| Last Update Date | 2013-12-19 |