| NPI | 1063979839 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS W WOOD Operations Director 517-759-5551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP2701X Psychologist, Group Psychotherapy |
| Enumeration Date | 2019-02-27 |
| Last Update Date | 2019-03-04 |