| NPI | 1295418960 |
|---|---|
| Former Legal Business Name | AWAKENING XPERIENCE PSYCHOLOGICAL SERVICES |
| Doing Business As | AWAKENING XPERIENCE PSYCHOLOGICAL SERVICES |
| Entity Type | Organization |
| Authorized Contact | MONIQUE CAMILLE TUCKER CEO 313-221-4313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Enumeration Date | 2023-08-09 |
| Last Update Date | 2023-08-09 |