| NPI | 1578138277 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP MENARD Clinical Director 734-657-1470 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 106E00000X Assistant Behavior Analyst | |
| 106S00000X Behavior Technician | |
| 2080P0006X Pediatrics Developmental - Behavioral Pediatrics | |
| 225X00000X Occupational Therapist | |
| 225XP0200X Occupational Therapist Pediatrics | |
| Enumeration Date | 2021-05-25 |
| Last Update Date | 2023-05-01 |