| NPI | 1225612518 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMRA E SAMUELS Behavioral Therapist 313-433-3267 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2021-05-12 |
| Last Update Date | 2022-08-08 |