| NPI | 1821263120 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW B GONZALEZ Owner 313-410-9626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI MG224080) |
| Enumeration Date | 2008-04-28 |
| Last Update Date | 2009-06-10 |