Doctor Name: | WILLIAM WILLARD PACE |
NPI Number: | 1093724049 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D., L.P. |
License Number: | LP2543 |
Business Practice Address: | 5851 Duluth St Suite 113 Golden Valley, MN - 554223946 |
Business Phone Number: | 6516453115 |
Business Fax Number: | 6516452752 |
Mailing Address: | 5851 Duluth St, Suite 113 GOLDEN VALLEY |
State: | MN |
Postal Code: | 554223946 |
Phone Number: | 6516453115 |
Fax Number: | 6516452752 |
NPI Enumeration Date: | 08/07/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103G00000X |
License Number: | LP2543 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | MN |
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. |