| NPI | 1174479190 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARMEN RASEAN EVANS Nurse Practitioner 313-282-8538 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2026-03-10 |
| Last Update Date | 2026-04-24 |