| NPI | 1770225906 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOBY KELLK-HAMANN Founder/President 248-629-0079 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 103T00000X Psychologist |
| 251S00000X | |
| 251V00000X Voluntary or Charitable | |
| Enumeration Date | 2022-04-08 |
| Last Update Date | 2022-04-08 |