| NPI | 1639430150 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL ANNE JOHNS Clinical Psychologist 586-254-2994 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301008454) |
| Enumeration Date | 2012-05-31 |
| Last Update Date | 2012-05-31 |