| NPI | 1063706141 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID HARRIS Owner/Operator 248-477-0110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TH0100X Psychologist, Health Service (Licence: MI 4301060044) |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2011-06-20 |