| NPI | 1760775944 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH ANN ROSE Clinical Psychologist 810-964-5901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301011940) |
| Enumeration Date | 2011-05-23 |
| Last Update Date | 2011-05-23 |