| NPI | 1003950015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY SSN RATOWSKI Director Of Provider Affairs 313-874-6764 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry | |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2024-06-14 |