NPI | 1194120097 |
---|---|
Entity Type | Organization |
Authorized Contact | LEATRICE RENEE BROOKS Psychologist 866-232-5389 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 6301015072) |
Enumeration Date | 2014-11-04 |
Last Update Date | 2019-06-11 |