| NPI | 1184898280 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MISSI NADEAU Sole Proprietor 231-722-7751 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301007867) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MI 6301007867) |
| 103TF0200X Psychologist, Forensic (Licence: MI 6301007867) | |
| 103TH0004X Psychologist, Health (Licence: MI 6301007867) | |
| Enumeration Date | 2008-04-18 |
| Last Update Date | 2008-04-18 |