| NPI | 1356716559 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEX J. GROSSBERG Credentialing Coordinator 248-626-1500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 103T00000X Psychologist |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2015-12-14 |
| Last Update Date | 2015-12-14 |