| NPI | 1437301330 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA ROOD Sr Syst EMS Analyst 234-312-5193 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical |
| Additional Taxonomies | 207QH0002X Family Medicine Hospice and Palliative Medicine |
| Enumeration Date | 2008-10-22 |
| Last Update Date | 2023-11-30 |