| NPI | 1053456525 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE M ROUSSEAU Licensed Psychologist 810-956-4389 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MI 6301012660) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2020-08-22 |