Organization
MANIJEH BOUSTANI, PH.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MANIJEH BOUSTANI PH.D. (PRESIDENT)
(919) 656-3589
Entity
Organization
Contact information
Practice address
602 OAK TREE DR, CHAPEL HILL, NC 27517-4072
(919) 656-3589
(919) 240-4698
Mailing address
602 OAK TREE DR, CHAPEL HILL, NC 27517-4072
(919) 656-3589
(919) 240-4698
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1456
NC
Other
Enumeration date
08/29/2012
Last updated
08/29/2012
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