Organization
NEUROGENESIS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUSTINE ASHOKAR PH. D. (PSYCHOLOGIST)
(605) 484-0560
Entity
Organization
Contact information
Practice address
1115 CHURCH ST NW STE J, HUNTSVILLE, AL 35801-5980
(605) 484-0560
Mailing address
10319 PICADILLY LN SW, HUNTSVILLE, AL 35803-2050
(605) 484-0560
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/16/2022
Last updated
09/21/2022
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