| NPI | 1386069110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELLE C JACKS PORTER CFO 989-894-3838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MI 4703086129) |
| Enumeration Date | 2014-03-04 |
| Last Update Date | 2018-08-09 |