| NPI | 1467709188 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID JUDD Owner 586-663-8906 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704199416) |
| Enumeration Date | 2012-08-13 |
| Last Update Date | 2015-03-05 |