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 |