| NPI | 1144524133 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI KANAT EDELSON Business Owner 248-646-6659 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2011-01-05 |
| Last Update Date | 2013-04-18 |