Doctor Name: | VINEESHA RATHNAM |
NPI Number: | 1154698793 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 1022 E Main St Benton Harbor, MI - 490223036 |
Business Phone Number: | 2699260015 |
Business Fax Number: | 2699260123 |
Mailing Address: | 3349 Pleasant St, BERRIEN SPRINGS |
State: | MI |
Postal Code: | 491039519 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 11/28/2011 |
NPI Last Update Date: | 11/28/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |