| NPI | 1760671671 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN J OLESNAVAGE Owner/President 906-225-1071 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301010173) |
| Enumeration Date | 2007-10-16 |
| Last Update Date | 2007-10-16 |