| NPI | 1942510425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANESSA J EDWARDS Practice Manager 616-954-1991 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 681092605) |
| Enumeration Date | 2010-10-18 |
| Last Update Date | 2010-10-18 |