Organization Name: | SUN HEALTH MEDICAL GROUP, LLC |
NPI Number: | 1093987646 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | WILLIAM T SELLNER (CHIEF FINANCIAL OFFICER) |
Mailing Address: | 13950 W Meeker Blvd Sun City West |
State: | AZ US |
Postal Code: | 853754423 |
Phone Number: | 6235445075 |
Fax Number: | 6235445093 |
NPI Enumeration Date: | 03/24/2008 |
NPI Last Update Date: | 03/24/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103G00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
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. |