| NPI | 1124491147 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL BANKS Owner/Psychotherapist 734-456-9006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301016295) |
| Enumeration Date | 2015-11-13 |
| Last Update Date | 2015-11-13 |