| NPI | 1992589881 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | JORDAN ELIZABETH BENNETT Mental Health Clinician/Therapist 810-356-7712  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 104100000X Social Worker | 
| Enumeration Date | 2023-08-22 | 
| Last Update Date | 2025-05-26 |