| NPI | 1205134525 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENE JOSEPH Administrator 248-703-1897 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist |
| 103T00000X Psychologist | |
| Enumeration Date | 2011-03-10 |
| Last Update Date | 2021-06-28 |