Organization Name: | CRIPPLED CHILDREN'S HOSPITAL |
NPI Number: | 1295958361 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SAMUEL G. WEIDMAN (VICE PREDIDENT & CFO) |
Mailing Address: | 2924 Brook Rd Richmond |
State: | VA US |
Postal Code: | 232201215 |
Phone Number: | 8043217474 |
Fax Number: | 8043212728 |
NPI Enumeration Date: | 04/10/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103G00000X |
License Number: | H1842 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | VA |
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. |