| NPI | 1174297436 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELYSE SOMERS ROCCO Clinical Psychologist 231-690-5306 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2021-08-02 |
| Last Update Date | 2021-08-02 |