| NPI | 1023710290 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLA ANN KEVERN Practitioner 231-215-3877 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 103TS0200X Psychologist, School | |
| Enumeration Date | 2023-03-20 |
| Last Update Date | 2023-03-20 |