| NPI | 1548672728 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YOJANA VEERAMASUNENI Practice Administrator 269-408-1688 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301015548) |
| Enumeration Date | 2014-05-22 |
| Last Update Date | 2023-05-09 |