| NPI | 1992174361 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN JONGEKRYG Clinical Social Worker 616-949-9006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801094737) |
| Enumeration Date | 2015-09-16 |
| Last Update Date | 2015-09-16 |