| NPI | 1407026115 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAYLE ANN GOZDOR Clinical Psychologist 313-730-2077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301007615) |
| Enumeration Date | 2008-03-10 |
| Last Update Date | 2011-09-26 |