| NPI | 1639621089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUTH MCLEISTER ANAN Owner 248-207-4107 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MI 6301010252) |
| Enumeration Date | 2016-11-02 |
| Last Update Date | 2016-11-02 |