| NPI | 1225469562 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLEEN A. THEBERT-WRIGHT Owner 269-384-6055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301012124) |
| Enumeration Date | 2013-12-12 |
| Last Update Date | 2013-12-12 |