| NPI | 1407180284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VLADIMIR ROBERT VANDALOV Owner 248-990-0140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401005273) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301000821) |
| 1041C0700X Social Worker, Clinical (Licence: MI 6801069906) | |
| Enumeration Date | 2009-09-25 |
| Last Update Date | 2010-07-27 |