Doctor Name: | DR. EVAN B. DRAKE |
NPI Number: | 1336214477 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | 003265 |
Business Practice Address: | 1281 E Main St Ste 104 Stamford, CT - 069023544 |
Business Phone Number: | 2033092707 |
Business Fax Number: | 8779512288 |
Mailing Address: | 23 Nickerson Ln, DARIEN |
State: | CT |
Postal Code: | 068205720 |
Phone Number: | 2033092707 |
Fax Number: | 8779512288 |
NPI Enumeration Date: | 11/22/2006 |
NPI Last Update Date: | 01/21/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103G00000X |
License Number: | 003265 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
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. |