| NPI | 1588227912 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELLE NEUSIUS Administrative Assistant 248-322-0003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| 103TC0700X Psychologist Clinical | |
| Enumeration Date | 2019-04-22 |
| Last Update Date | 2019-06-11 |