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General NPI Number Information
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NPI Number | 1457151342
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Entity Type | Organization
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Legal Business Name | PSYCHOLOGICAL IMMIGRATION EVALUATIONS AND ASSESSMENT
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Dates
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Enumeration Date | 03/18/2025
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Last Update Date | 03/20/2025
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Provider Practice Location Address
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Address Line | 1030 XENIA AVE STE 6
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City | YELLOW SPRINGS
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State | OH
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Zip | 45387-1632
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Country | US
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Telephone | 937-254-9253
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Fax | 937-963-0908
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Provider Business Mailing Address
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Address Line | 161 E HERMAN ST
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City | YELLOW SPRINGS
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State | OH
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Zip | 45387-1602
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Country | US
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Telephone | 937-254-9253
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Fax | 937-963-0908
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Authorized Official
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Title or Position | OWNER
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Name | ERENDIRA LOPEZ-GARCIA
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Credential |
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Telephone | 937-254-9253
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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