| NPI | 1114523156 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOMONIKA TIPTON Therapist 734-627-7669 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2020-12-06 |
| Last Update Date | 2024-10-30 |