| NPI | 1609173921 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANET S REED Member, Director 586-913-1038 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MI 6301012828) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301012828) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MI 6301012828) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: MI 6301012828) | |
| Enumeration Date | 2011-02-23 |
| Last Update Date | 2011-02-23 |