| NPI | 1790391365 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDICE WEST Office Admin 937-360-8434 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry |
| Enumeration Date | 2020-09-19 |
| Last Update Date | 2021-01-21 |