Provider Demographics
NPI:1235755257
Name:INTEGRATED BEHAVIORAL HEALTH, PLLC
Entity Type:Organization
Organization Name:INTEGRATED BEHAVIORAL HEALTH, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAANISH
Authorized Official - Middle Name:
Authorized Official - Last Name:QALBANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-518-3907
Mailing Address - Street 1:759 HOWARD AVE
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39530-4305
Mailing Address - Country:US
Mailing Address - Phone:228-374-2100
Mailing Address - Fax:228-432-5539
Practice Address - Street 1:759 HOWARD AVE
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39530-4305
Practice Address - Country:US
Practice Address - Phone:228-374-2100
Practice Address - Fax:228-432-5539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-25
Last Update Date:2020-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty