Doctor Name: | DR. JARED BRUCE |
NPI Number: | 1588954200 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | 2008007983 |
Business Practice Address: | 10555 Marty St Ste 100 Overland Park, KS - 662122555 |
Business Phone Number: | 9136498823 |
Business Fax Number: | |
Mailing Address: | 2107 W 78th St, PRAIRIE VILLAGE |
State: | KS |
Postal Code: | 662083812 |
Phone Number: | 4014994043 |
Fax Number: | |
NPI Enumeration Date: | 04/14/2011 |
NPI Last Update Date: | 04/14/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103G00000X |
License Number: | 2008007983 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MO |
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. |