| NPI | 1891906061 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOAN MARY INWALD Treasurer 248-723-9200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MI JI007220) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MI JI007220) |
| 103TC0700X Psychologist, Clinical (Licence: MI JI007200) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MI JI007220) | |
| 103TF0200X Psychologist, Forensic (Licence: MI JI007220) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: MI JI007220) | |
| 103TR0400X Psychologist, Rehabilitation (Licence: MI JI007220) | |
| Enumeration Date | 2007-05-26 |
| Last Update Date | 2020-08-22 |