| NPI | 1912387697 |
|---|---|
| Doing Business As | JASON WHEATLEY, LMSW |
| Entity Type | Organization |
| Authorized Contact | JASON WHEATLEY Clinical D Irector 810-347-8143 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801086655) |
| Enumeration Date | 2015-06-08 |
| Last Update Date | 2015-06-08 |