| NPI | 1083015499 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL WALL Owner 248-881-6698 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YP2500X Counselor, Professional | |
| 103T00000X Psychologist | |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2014-09-05 |
| Last Update Date | 2023-06-07 |