| NPI | 1780410175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA QUINN Director Of Operations 586-286-5870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| 103TC1900X Psychologist Counseling | |
| Enumeration Date | 2024-09-11 |
| Last Update Date | 2024-09-12 |