Organization Name: | CAMPBELL NEUROPSYCHOLOGICAL SERVICES, PC |
NPI Number: | 1205815495 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DEREK CAMPBELL (PRESIDENT) |
Mailing Address: | 6165 Nw 86th St Johnston |
State: | IA US |
Postal Code: | 501312270 |
Phone Number: | 5152522522 |
Fax Number: | 5152522523 |
NPI Enumeration Date: | 01/16/2006 |
NPI Last Update Date: | 10/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103G00000X |
License Number: | 00899 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
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. |