| NPI | 1609290451 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACIE DURANT Chief Financial Officer 313-344-9099 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent |
| Additional Taxonomies | 103TF0000X Psychologist, Family |
| Enumeration Date | 2014-02-14 |
| Last Update Date | 2016-10-24 |