| NPI | 1093984817 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH DATE Business Director 989-832-2165 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301009535) |
| Enumeration Date | 2008-02-26 |
| Last Update Date | 2021-03-16 |