| NPI | 1245191485 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAIME LYNN SUTHERLAND Owner 313-530-4656 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2025-11-18 |
| Last Update Date | 2025-11-18 |