| NPI | 1417189523 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BERNADETTE STARR KOVACH Sole Proprietor 734-812-1157 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP0814X Psychologist Psychoanalysis |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MI 6301012246) |
| Enumeration Date | 2009-08-23 |
| Last Update Date | 2024-02-12 |