| NPI | 1841321072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YOJANA VEERAMASUNENI Administrator 269-408-1688 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4301044215) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301015548) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2022-11-10 |