| NPI | 1790110187 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE ERIN MCGILLIVARY Owner 734-355-2833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center Developmental Disabilities (Licence: MI 6301011704) |
| Additional Taxonomies | 225XP0200X Occupational Therapist Pediatrics |
| 235Z00000X Speech-Language Pathologist | |
| Enumeration Date | 2013-09-05 |
| Last Update Date | 2025-08-17 |