| NPI | 1073242632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY MICHAEL KOTLARZ Owner/Licensed Psychologist 248-398-7574 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TH0004X Psychologist, Health |
| Enumeration Date | 2022-06-08 |
| Last Update Date | 2022-09-07 |