| NPI | 1710388913 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AIMEE KOTRBA Owner 810-225-3417 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MI 1033328166) |
| Enumeration Date | 2014-09-08 |
| Last Update Date | 2014-09-08 |