| NPI | 1780103382 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBEKAH HANSEN Clinical Psychologist 734-223-3520 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301014921) |
| Enumeration Date | 2017-09-14 |
| Last Update Date | 2017-09-14 |