| NPI | 1194869107 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY RATOWSKI Director Of Provider Affairs 248-703-2003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2024-03-06 |