Provider Demographics
NPI:1750025177
Name:EDRISINHA, CHATURI (PHD, BCBA-D, LBA-D)
Entity Type:Individual
Prefix:DR
First Name:CHATURI
Middle Name:
Last Name:EDRISINHA
Suffix:
Gender:F
Credentials:PHD, BCBA-D, LBA-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:904 HILLSIDE CT
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-2138
Mailing Address - Country:US
Mailing Address - Phone:248-840-5595
Mailing Address - Fax:
Practice Address - Street 1:904 HILLSIDE CT
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-2138
Practice Address - Country:US
Practice Address - Phone:248-840-5595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-21
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7401001127103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst