| NPI | 1558832873 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA LOUISE Owner/Manager 248-703-4920 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2018-12-14 |
| Last Update Date | 2018-12-14 |