| NPI | 1417194697 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH GROGAN Clinical Psychologist 248-320-4215 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: MI 631040) |
| Enumeration Date | 2009-01-09 |
| Last Update Date | 2009-01-09 |