| NPI | 1144162835 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN MANGENJE Owner / Np / Provider 248-413-5013 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2026-04-09 |
| Last Update Date | 2026-04-09 |