| NPI | 1548120124 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL BLAIR-HOUSTON Owner 313-999-8724 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2025-11-14 |
| Last Update Date | 2026-03-07 |