| NPI | 1629591185 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANA MARYSE SHAPERO Clinical Psychologist 248-246-6767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: MI 6301015580) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MI 6301015580) |
| Enumeration Date | 2017-07-17 |
| Last Update Date | 2022-07-21 |