| NPI | 1154727147 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT A CLEMENTE Authorized Representative 248-894-0668 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TC0700X Psychologist, Clinical | |
| 1041C0700X Social Worker, Clinical | |
| 363A00000X Physician Assistant | |
| 363LA2200X Nurse Practitioner, Adult Health | |
| 363LF0000X Nurse Practitioner, Family | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2014-11-18 |
| Last Update Date | 2024-07-25 |