| NPI | 1508171455 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER G GILLETTE Social Worker/Psychotherapist 248-224-2930 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X (Licence: MI 6801081393) |
| Enumeration Date | 2010-08-16 |
| Last Update Date | 2010-08-16 |