Doctor Name: | JUNE RESTREPO |
NPI Number: | 1669799508 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 2867057 |
Business Practice Address: | 3601 30th Ave Suite 102 Kenosha, WI - 531441695 |
Business Phone Number: | 2626540487 |
Business Fax Number: | 2626542434 |
Mailing Address: | 5027 Green Bay Rd, Ste 120 KENOSHA |
State: | WI |
Postal Code: | 531441771 |
Phone Number: | 2626721334 |
Fax Number: | 8552772812 |
NPI Enumeration Date: | 05/03/2010 |
NPI Last Update Date: | 05/19/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103G00000X |
License Number: | 2867057 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
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. |