| NPI | 1487892311 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKIE L BERGEN Clinical Psychologist 248-444-7711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301008768) |
| Enumeration Date | 2009-01-30 |
| Last Update Date | 2009-01-30 |