| NPI | 1871945683 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA WOLF Owner/Authorized Official 734-730-5534 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301015616) |
| Enumeration Date | 2016-07-05 |
| Last Update Date | 2016-07-05 |