| NPI | 1962541318 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRED KORTE CFO 810-342-2000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2018-08-09 |