NPI | 1770596587 |
---|---|
Entity Type | Organization |
Authorized Contact | WILLIAM PHILLIP BLOOM Managing Partner 248-649-9202 |
Organization Subpart ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301006833) |
Enumeration Date | 2006-08-14 |
Last Update Date | 2020-08-22 |