| NPI | 1386066678 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL LUCKI SMITH Owner 248-656-8500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| Enumeration Date | 2014-01-06 |
| Last Update Date | 2014-01-06 |