| NPI | 1891573770 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI FRANCES GRANT Manager 586-651-0090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2023-09-20 |
| Last Update Date | 2023-09-20 |