| NPI | 1053610782 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLEN LOUISE KEYT Clinical Psychologist 313-492-0166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301014137) |
| Enumeration Date | 2011-03-21 |
| Last Update Date | 2011-03-21 |