| Organization Name: | PAUL W MACELLARI PHD PC |
| NPI Number: | 1285013474 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PAUL WARREN MACELLARI (PRESIDENT) |
| Mailing Address: | 135 Red Coach Dr Mishawaka |
| State: | IN US |
| Postal Code: | 465453145 |
| Phone Number: | 5742549200 |
| Fax Number: | 5742549202 |
| NPI Enumeration Date: | 05/21/2015 |
| NPI Last Update Date: | 05/21/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103G00000X |
| License Number: | 20040273 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| 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. |