| NPI | 1235334939 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID MICHAEL COWAN Owner 248-745-0425 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MI 6301005488) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: MI 6301005488) |
| 103T00000X Psychologist (Licence: MI 6301005488) | |
| 103TF0200X Psychologist Forensic (Licence: MI 6301005488) | |
| 103TH0004X Psychologist Health (Licence: MI 6301005488) | |
| 103TR0400X Psychologist Rehabilitation (Licence: MI 6301005488) | |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2007-10-27 |