| NPI | 1538272828 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY N. AXELROD Psychologist 313-576-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QV0200X Clinic/Center, VA (Licence: MI 6301007688) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2020-08-22 |