| NPI | 1104200070 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHONDA R JANKE-STEDRONSKY Owner 228-365-4462 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX P3174) |
| Enumeration Date | 2015-07-10 |
| Last Update Date | 2015-07-10 |