| NPI | 1689100729 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MITCHELL S PARKER Owner 248-338-1700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301011448) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2017-05-11 |