| NPI | 1902397763 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | REBECCA DERAUD Owner 248-396-6271 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 104100000X Social Worker | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801080766) | 
| Enumeration Date | 2018-05-28 | 
| Last Update Date | 2021-04-19 |