| NPI | 1295024362 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEX J. GROSSBERG Credentialing COO Rdinator 248-626-1500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent |
| 1041C0700X Social Worker Clinical | |
| 2084P0800X Psychiatry & Neurology Psychiatry | |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry | |
| Enumeration Date | 2011-03-29 |
| Last Update Date | 2011-03-29 |