| NPI | 1033458393 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONCEPCION TY ANCOG Owner 246-646-5288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4301404778) |
| Enumeration Date | 2013-02-06 |
| Last Update Date | 2013-02-06 |