| NPI | 1720384415 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN CLARE O'DONNELL Partner 231-929-9511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301011534) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301011799) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MI 6301011799) | |
| Enumeration Date | 2011-01-28 |
| Last Update Date | 2011-01-28 |