| NPI | 1104674621 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANA SUCCURRO Owner 248-667-8014 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2024-05-09 |
| Last Update Date | 2024-09-30 |