| NPI | 1023288669 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS SELZNICK Owner 734-402-0254 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0805X |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2008-03-11 |
| Last Update Date | 2008-03-11 |