| NPI | 1528672615 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER CARTER Billing Supervisor 517-337-6545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP2701X Psychologist, Group Psychotherapy |
| Enumeration Date | 2020-09-04 |
| Last Update Date | 2021-02-03 |