| NPI | 1508001090 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI BOOTHROYD Licensed Psychologist 231-929-4722 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 6301012397) |
| Enumeration Date | 2008-12-11 |
| Last Update Date | 2012-08-10 |