| NPI | 1891303012 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUANIKA L. BENSON Psychotherapist 313-247-4413 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 102L00000X Psychoanalyst | |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| 103TF0000X Psychologist, Family | |
| 103TP2701X Psychologist, Group Psychotherapy | |
| Enumeration Date | 2020-07-14 |
| Last Update Date | 2020-07-14 |