Organization Name: | RICHARD S. GROSS, PH.D,,PC |
NPI Number: | 1396907333 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RICHARD SAUL GROSS (CLINICAL PSYCHOLOGIST) |
Mailing Address: | 2711 Irvin Way Suite 211 Decatur |
State: | GA US |
Postal Code: | 300305405 |
Phone Number: | 4045309776 |
Fax Number: | 7709395341 |
NPI Enumeration Date: | 07/01/2008 |
NPI Last Update Date: | 07/01/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103G00000X |
License Number: | 000371 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
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. |