| NPI | 1013213735 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLEY A TAGLIONE Billing Manager 734-414-0754 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301005752) |
| Enumeration Date | 2011-01-27 |
| Last Update Date | 2011-01-27 |