| NPI | 1457560963 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAHIJA KOTTAPALLI Owner 304-757-4032 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WV 21183) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2020-08-22 |