| Organization Name: | CLINICAL NEUROPSYCHOLOGICAL SERVICES, INC. |
| NPI Number: | 1043348600 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MATTHEW P ZICCARDI (OWNER) |
| Mailing Address: | 1045 Mackenzie Dr Lima |
| State: | OH US |
| Postal Code: | 458051660 |
| Phone Number: | 4192225672 |
| Fax Number: | 4192226786 |
| NPI Enumeration Date: | 03/02/2007 |
| NPI Last Update Date: | 04/15/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |