| NPI | 1912319831 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS DION MULLENS Owner/Member 616-403-0783 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801089541) |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2014-05-27 |