| NPI | 1811710668 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE E PREMO Owner/Clinical Psychologist 734-249-8828 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2024-10-31 |
| Last Update Date | 2025-01-02 |