| NPI | 1447336573 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEDOSHIA CARTER Provider 313-933-1956 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TM1800X Psychologist Mental Retardation & Developmental Disabilities |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2022-07-21 |