| NPI | 1083858104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLEY WILLBRANDT Sr. Director Beaumont Shared Svcs 947-522-1911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301006461) |
| Enumeration Date | 2009-04-21 |
| Last Update Date | 2022-06-30 |