| NPI | 1831315191 |
|---|---|
| Former Legal Business Name | ALLIED MENTAL HEALTH SPECIALTY GROUP SC |
| Entity Type | Organization |
| Authorized Contact | BRADLEY G NEVINS Owner 715-808-0795 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: WI 1436-057) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2020-05-09 |