| NPI | 1548750623 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHANNA EASTMAN BUZOLITS Owner 734-646-0885 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301012437) |
| Enumeration Date | 2018-05-15 |
| Last Update Date | 2018-05-15 |