| NPI | 1639558620 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTONINO AGOSTA Owner 248-678-8606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301015487) |
| Enumeration Date | 2015-05-22 |
| Last Update Date | 2022-03-08 |