| NPI | 1265053029 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HENRY M TRAURIG President 248-644-8533 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent |
| Enumeration Date | 2020-05-04 |
| Last Update Date | 2020-05-04 |