| NPI | 1891245775 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEMETRIUS EDWIN FORD Psychologist 313-806-7552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: MI 6301015998) |
| Enumeration Date | 2016-10-04 |
| Last Update Date | 2016-10-04 |