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Organization

92ND STREET PSYCH LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BIANCA OLIVERA (PRACTICE MANAGER)
(330) 294-4408
Entity
Organization

Contact information

Practice address
72 N MAIN ST STE 207, HUDSON, OH 44236-2867
(330) 294-4408
Mailing address
72 N MAIN ST STE 207, HUDSON, OH 44236-2867
(330) 294-4408
(234) 269-5428

Taxonomy

Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary

Other

Enumeration date
03/05/2025
Last updated
04/15/2026
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