| NPI | 1013145879 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE KOELTZOW Clinic Director 734-657-8059 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301011430) |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2009-06-30 |