| NPI | 1346874708 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA A NELSON Credentialing 906-233-1236 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 225100000X Physical Therapist | |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist | |
| Enumeration Date | 2020-02-25 |
| Last Update Date | 2020-02-25 |