| NPI | 1235373374 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSALYNN MARIE MOTEN-TRAVIS Clinical Director 313-719-1649 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301011759) |
| Enumeration Date | 2009-04-20 |
| Last Update Date | 2009-04-20 |