| NPI | 1700184694 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEGAN MCCLAIN Office Manager 248-620-1019 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301014240) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301002413) |
| Enumeration Date | 2011-03-02 |
| Last Update Date | 2011-03-02 |