| NPI | 1609622638 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | CYNTHIA SHIELDS Nurse Practitioner 586-315-2874  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health | 
| Enumeration Date | 2024-04-29 | 
| Last Update Date | 2025-10-14 |