| NPI | 1710248810 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNELLE MARIE KIRSANOFF Owner/Psychotherapist 248-850-1546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801085078) |
| Enumeration Date | 2012-06-05 |
| Last Update Date | 2012-06-05 |