NPI | 1437464229 |
---|---|
Entity Type | Organization |
Authorized Contact | KRISTINE PROCTOR Owner 269-405-0653 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301013553) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801069783) |
Enumeration Date | 2010-08-17 |
Last Update Date | 2010-08-17 |