| NPI | 1306827191 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE T. WENTWORTH President 586-997-3153 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301007769) |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2009-04-06 |