| NPI | 1760872568 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA KIMBERLY LARGO-MARSH Licensed Psychologist/Member Owner 269-629-2207 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301008181) |
| Enumeration Date | 2015-01-31 |
| Last Update Date | 2015-11-02 |