| NPI | 1356184626 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA KOPP Owner 248-296-6579 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| 103TC1900X Psychologist Counseling | |
| Enumeration Date | 2024-06-14 |
| Last Update Date | 2024-07-09 |