| NPI | 1619109501 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY SANSOM JONES Sole Proprietor 906-228-6200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301010832) |
| Enumeration Date | 2009-08-11 |
| Last Update Date | 2022-09-22 |