Organization
ENEZIAH WALTERS LCSW LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY BETH HOUPT (CREDENTIALING)
(517) 676-9797
Entity
Organization
Contact information
Practice address
2111 UNIVERSITY PARK DR STE 400, OKEMOS, MI 48864-6907
(517) 512-5289
Mailing address
134 W MAPLE ST, MASON, MI 48854-1657
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
06/08/2022
Last updated
11/27/2023
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