| NPI | 1700380664 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENELLE MAZARIS Clinical Director 734-748-3140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MI 4101006577) |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2018-03-23 |