| NPI | 1811219678 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT J FLEWELLING CEO 248-980-7997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301014084) |
| Enumeration Date | 2010-02-22 |
| Last Update Date | 2012-12-03 |