| NPI | 1003626581 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS TILLOTSON CEO 248-770-9929 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TM1800X Psychologist, Intellectual & Developmental Disabilities |
| Additional Taxonomies | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics |
| Enumeration Date | 2025-01-08 |
| Last Update Date | 2025-02-07 |