| NPI | 1609021369 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE JEAN STEWART Practice Manager 269-343-3010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling |
| Enumeration Date | 2008-11-22 |
| Last Update Date | 2008-11-22 |