| NPI | 1528612843 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEADIA CAREY Clinician 248-251-0354 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2019-07-25 |
| Last Update Date | 2019-09-05 |