South Mi Psychiatric Services LLC

NPI #1932635521 in Portage, Michigan

Provider Information

NPI Number: 1932635521
Entity Type: Organization
Organization Name: South Mi Psychiatric Services LLC
Primary Specialty: Psychologist - Prescribing (Medical)
Enumeration Date: May 3, 2017
Last Updated: May 3, 2017

Practice Location

Address: 5930 LOVERS LN STE 3
City: Portage
State: Michigan
ZIP Code: 49002-1673
Phone: (269) 381-6950

Authorized Official

Name: RUQIYA TAREEN, M.D.
Title: MEDICAL DIRECTOR
Phone: (269) 381-6950

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - Prescribing (Medical) — Prescribing (Medical)	103TP0016X	Primary

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