| NPI | 1851144224 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORA ALA IMSAIAH Owner/Psychologist 248-658-8121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical |
| Additional Taxonomies | 102L00000X Psychoanalyst |
| 103T00000X Psychologist | |
| 103TA0400X Psychologist Addiction (Substance Use Disorder) | |
| 103TB0200X Psychologist Cognitive & Behavioral | |
| 103TC1900X Psychologist Counseling | |
| 103TC2200X Psychologist Clinical Child & Adolescent | |
| 103TP2701X Psychologist Group Psychotherapy | |
| 163WP0808X Registered Nurse Psychiatric/Mental Health | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2024-04-08 |
| Last Update Date | 2024-04-08 |