| NPI | 1922499375 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER MILLER Executive Manager 248-548-6735 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301003142) |
| Enumeration Date | 2015-02-06 |
| Last Update Date | 2015-02-06 |