Organization
PROFESSIONAL BEHAVIORAL SUPPORT LLC
Active
Other names
Professional Behavioral Support LLC
Organization subpart
No
Provider details
NPI number
Authorized official
ELIETH KOKWESIGA KAMALA CNP (PSCHIATRIC NURSE PRACTICTITIONER)
(614) 574-1823
Entity
Organization
Contact information
Practice address
691 E DUBLIN GRANVILLE RD, COLUMBUS, OH 43229-3209
(614) 715-2154
(614) 705-6577
Mailing address
691 E DUBLIN GRANVILLE RD, COLUMBUS, OH 43229-3209
(614) 574-1824
(614) 420-2229
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
07/06/2023
Last updated
12/09/2023
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