| NPI | 1053493825 |
|---|---|
| Other Name | NORTHBANK COUNSELING SERVICES, P.C. |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301003045) |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2007-07-08 |