| NPI | 1720284284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FIROZA B VAN HORN Owner 248-858-8412 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301007958) |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2018-03-29 |