Organization Name: | NEUROPSYCHOLOGICAL CONSULTANTS INC |
NPI Number: | 1013059187 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TERESA M. D DEER (PRESIDENT) |
Mailing Address: | 3601 30th Ave Suite 102 Kenosha |
State: | WI US |
Postal Code: | 531441695 |
Phone Number: | 2626540487 |
Fax Number: | |
NPI Enumeration Date: | 02/13/2007 |
NPI Last Update Date: | 07/26/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103G00000X |
License Number: | 2518-057 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Clinical Neuropsychologist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |