| NPI | 1578514584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEWIS WILSON SMITH Licensed Psychologist 248-644-2955 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MI 6201002143) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301002143) |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2014-09-16 |