| NPI | 1801099965 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL LUCKI SMITH President 586-747-0206 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301012845) |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2020-08-22 |