| NPI | 1942507579 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURI LYNN KELLER Social Worker 810-423-1008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MI 680108821) |
| Enumeration Date | 2011-02-16 |
| Last Update Date | 2011-03-15 |