| NPI | 1578050845 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA KOPP Owner 248-296-6579 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301014628) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MI 6401010461) |
| 103T00000X Psychologist (Licence: MI 6301014332) | |
| Enumeration Date | 2018-04-21 |
| Last Update Date | 2022-08-10 |