| NPI | 1336409804 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA KNOWLES Sole Proprietor 248-320-1196 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MI 6301014248) |
| Enumeration Date | 2012-05-18 |
| Last Update Date | 2012-05-18 |