Provider Demographics
NPI:1457151342
Name:PSYCHOLOGICAL IMMIGRATION EVALUATIONS AND ASSESSMENT
Entity type:Organization
Organization Name:PSYCHOLOGICAL IMMIGRATION EVALUATIONS AND ASSESSMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERENDIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ-GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-254-9253
Mailing Address - Street 1:161 E HERMAN ST
Mailing Address - Street 2:
Mailing Address - City:YELLOW SPRINGS
Mailing Address - State:OH
Mailing Address - Zip Code:45387-1602
Mailing Address - Country:US
Mailing Address - Phone:937-254-9253
Mailing Address - Fax:937-963-0908
Practice Address - Street 1:1030 XENIA AVE STE 6
Practice Address - Street 2:
Practice Address - City:YELLOW SPRINGS
Practice Address - State:OH
Practice Address - Zip Code:45387-1632
Practice Address - Country:US
Practice Address - Phone:937-254-9253
Practice Address - Fax:937-963-0908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-18
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty