| NPI | 1154821783 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLEY BONANNO Owner 586-917-4001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2018-02-20 |
| Last Update Date | 2018-03-17 |