| NPI | 1568964872 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LACARA S GILMORE Owner/Operator 734-404-8729 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MI 4101006791) |
| Enumeration Date | 2018-03-02 |
| Last Update Date | 2018-05-09 |