| NPI | 1598470320 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAYLA GLASS Therapist 248-763-2399 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103T00000X Psychologist | |
| Enumeration Date | 2023-01-16 |
| Last Update Date | 2023-01-16 |