NPI | 1104358597 |
---|---|
Entity Type | Organization |
Authorized Contact | SHANKAR YALAMANCHILI Owner 334-239-2622 |
Organization Subpart ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry |
Additional Taxonomies | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
Enumeration Date | 2017-04-03 |
Last Update Date | 2017-04-03 |