| NPI | 1326342502 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RALPH LLOYD OLSON Owner 906-225-5462 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301008509) |
| Enumeration Date | 2011-01-03 |
| Last Update Date | 2023-03-29 |