| NPI | 1972474799 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUILIAN MICHAEL TOWNSLEY BASS Clinical Psychologist 313-231-5335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2025-09-15 |
| Last Update Date | 2025-09-15 |