| NPI | 1306268396 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS W CARPENTER Founding Member 248-670-2861 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MI 6301013009) |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| 103T00000X Psychologist | |
| 1041C0700X Social Worker Clinical (Licence: MI 6801084631) | |
| Enumeration Date | 2014-01-10 |
| Last Update Date | 2020-07-28 |