| NPI | 1972019917 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | JATERA K MAING Licensed Clinical Social Worker 734-386-0560 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801093525) | 
| Enumeration Date | 2017-12-27 | 
| Last Update Date | 2020-01-30 |