| NPI | 1073040093 |
|---|---|
| Other Name | LIMITED LICENSE PSYCHOLOGY |
| Entity Type | Organization |
| Authorized Contact | JODIE ROBERTS Manager 248-641-4041 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2017-05-22 |
| Last Update Date | 2024-08-23 |