| NPI | 1326599036 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE KUPTZ Billing Supervisor 586-226-3440 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 103TC0700X Psychologist, Clinical | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry | |
| Enumeration Date | 2016-10-18 |
| Last Update Date | 2016-10-18 |