Organization
OCTAVE BEHAVIORAL MICHIGAN PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KYM EVERETT (VP REVENUE OPERATIONS)
(650) 504-2289
Entity
Organization
Contact information
Practice address
508 MEETING ST, WEST COLUMBIA, SC 29169-7535
(415) 360-3833
(628) 234-3048
Mailing address
PO BOX 18481, PALATINE, IL 60055-8481
(415) 360-3833
(628) 234-3048
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
01/03/2025
Last updated
03/24/2025
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