| NPI | 1487850343 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE B TREBILCOCK Psychologist 517-449-0043 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301007023) |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2011-11-22 |