| NPI | 1851748768 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER LYNN DERMYER Psychologist 906-250-3191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301014186) |
| Enumeration Date | 2016-05-20 |
| Last Update Date | 2016-05-20 |