| NPI | 1558556332 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALE THOMPSON CFO 517-975-7555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 064510) |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2007-09-13 |
| Last Update Date | 2018-08-02 |