| NPI | 1912439662 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEA ALEAS WHITE Owner 248-509-4358 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801063405) |
| Enumeration Date | 2017-03-31 |
| Last Update Date | 2018-02-27 |