| NPI | 1356735468 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE WENTWORTH President/CEO 586-997-3153 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301015522) |
| Enumeration Date | 2015-03-26 |
| Last Update Date | 2015-03-26 |