| NPI | 1528831195 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONSTANCE RHODES VICTOR Psychologist 248-943-0278 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2023-11-06 |
| Last Update Date | 2024-10-08 |