| NPI | 1124132899 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEVERLY A COSTINEW Administrative Director 248-478-0422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP2701X Psychologist, Group Psychotherapy |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2007-07-17 |