| NPI | 1861512329 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFRY BRUCE HILLENBERG Sole Member 248-892-4364 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301006433) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2007-07-22 |