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General NPI Number Information
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NPI Number | 1225219272
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Entity Type | Organization
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Legal Business Name | KALPANA VISHNUPAD, LLC
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Dates
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Enumeration Date | 11/19/2007
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Last Update Date | 02/27/2013
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Provider Practice Location Address
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Address Line | 1458 CLEAR BROOK DR
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City | DAYTON
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State | OH
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Zip | 45440-4317
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Country | US
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Telephone | 937-848-9130
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Fax | 937-848-3329
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Provider Business Mailing Address
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Address Line | 1458 CLEAR BROOK DR
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City | DAYTON
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State | OH
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Zip | 45440-4317
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | KALPANA VISHNUPAD
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Credential | M.D.
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Telephone | 937-848-9130
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TP0016X
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Taxonomy Name | Prescribing (Medical) Psychologist
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License Number | 35-07-3908-V
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License Number State | OH
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