NPI | 1154470755 |
---|---|
Entity Type | Organization |
Authorized Contact | CHARLES EARNEST CAPICCHIONI Director 248-355-4300 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301012712) |
Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: MI 6301010435) |
Enumeration Date | 2007-01-10 |
Last Update Date | 2010-12-01 |