| NPI | 1669533865 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY SSN RATOWSKI Director Of Provider Affairs 248-703-2003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 830190) |
| Additional Taxonomies | 170300000X Genetic Counselor, MS |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2024-03-15 |