Organization Name: | WILLIAM J. MCINTOSH PHD PC |
NPI Number: | 1710144001 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | WILLIAM J MCINTOSH (PRINCIPAL) |
Mailing Address: | 1439 Mclendon Dr Ste D Decatur |
State: | GA US |
Postal Code: | 300331841 |
Phone Number: | 7704939777 |
Fax Number: | |
NPI Enumeration Date: | 05/22/2008 |
NPI Last Update Date: | 05/22/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103G00000X |
License Number: | PSY000316 |
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. |