NPI | 1073810644 |
---|---|
Entity Type | Organization |
Authorized Contact | KAREN O ANDERSON Office Manager 313-664-4900 |
Organization Subpart ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401001940) |
Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
103TC0700X Psychologist, Clinical (Licence: MI 6301011558) | |
103TC2200X Psychologist, Clinical Child & Adolescent | |
103TF0000X Psychologist, Family | |
103TP2701X Psychologist, Group Psychotherapy | |
1041C0700X Social Worker, Clinical (Licence: MI 6801068236) | |
1041S0200X Social Worker, School (Licence: MI 6301011558) | |
106H00000X Marriage & Family Therapist | |
235Z00000X Speech-Language Pathologist, (Licence: MD 12068248) | |
Enumeration Date | 2011-02-17 |
Last Update Date | 2016-12-13 |