| NPI | 1922839877 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAYNA AGOSTA Therapist 248-716-4196 |
| Organization Subpart ? | No |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2024-08-12 |
| Last Update Date | 2024-09-24 |