| NPI | 1205126943 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANIL KUMAR GUPTA Owner 229-244-2030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2011-04-14 |
| Last Update Date | 2020-09-08 |