| NPI | 1043424690 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL P GUSHO CFO Se Mi Region 248-858-6174 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| 103T00000X Psychologist | |
| 103TC0700X Psychologist, Clinical | |
| 103TP0016X Psychologist, Prescribing (Medical) | |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2017-10-05 |