| NPI | 1306957444 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY L SCHWEDA Psychologist 517-780-0809 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301010119) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6302006268) |
| 261QM1300X Clinic/Center, Multi-Specialty (Licence: MI 4301044183) | |
| 261QM2500X Clinic/Center, Medical Specialty (Licence: MI 4301044183) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-08-22 |