| NPI | 1841694296 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE LONSWAY Psychologist 586-291-2503 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301015757) |
| Enumeration Date | 2014-10-14 |
| Last Update Date | 2014-10-14 |