| NPI | 1346976891 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL KIMBALL Clinical Psychologist 734-693-0554 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2022-07-27 |
| Last Update Date | 2022-08-05 |