| NPI | 1811367667 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM WARREN FITZGERALD Sole Proprietor 269-224-1545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: MI 6301015983) |
| Enumeration Date | 2015-10-05 |
| Last Update Date | 2015-10-05 |