Organization
MODERN PSYCHIATRY AND WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. QUINTON MOSS MD (CEO)
(513) 868-0055
Entity
Organization
Contact information
Practice address
1910 FAIRGROVE AVE STE E, HAMILTON, OH 45011-1930
(513) 795-7557
(513) 297-7577
Mailing address
1910 FAIRGROVE AVE STE E, HAMILTON, OH 45011-1930
(513) 795-7557
(513) 297-7577
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2444144
—
OH
Enumeration date
08/17/2009
Last updated
10/27/2020
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