Organization
MICHIANA NEUROSCIENCE, LLC
Active
Parent organization
-
Other names
Michiana NeuroScience, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
-
Authorized official
DR. MICHAEL RICHARD MITCHEFF PSYD (DIRECTOR PSYCHOLOGY)
(574) 229-9695
Entity
Organization
Contact information
Practice address
210 S RACE ST, MISHAWAKA, IN 46544-2032
(574) 229-9695
Mailing address
210 S RACE ST, MISHAWAKA, IN 46544-2032
(574) 229-9695
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
20042941A
IN
Other
Enumeration date
08/24/2018
Last updated
08/24/2018
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