| NPI | 1962541375 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRAMILA VELLANKI Office Manager 937-342-9030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: OH 35063060) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: OH I.0002982) |
| 104100000X Social Worker (Licence: OH I.0002982) | |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: OH 35063060) | |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2024-07-22 |