Doctor Name: | DR. MAXIMILLIAN SHMIDHEISER |
NPI Number: | 1477709830 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PSY.D. |
License Number: | |
Business Practice Address: | 1200 W Tabor Rd Philadelphia, PA - 191413019 |
Business Phone Number: | 2154569383 |
Business Fax Number: | |
Mailing Address: | 500 Admirals Way, Apartment 209 PHILADELPHIA |
State: | PA |
Postal Code: | 191465223 |
Phone Number: | 2157046003 |
Fax Number: | |
NPI Enumeration Date: | 08/15/2008 |
NPI Last Update Date: | 03/25/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103G00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
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. |