Organization Name: | CENTER FOR NEUROBEHAVIORAL DISORDERS, LLC |
NPI Number: | 1710321229 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KAREN ELENA LEE (NEUROPSYCHOLOGIST) |
Mailing Address: | 2490 N Water St Suite 9 Decatur |
State: | IL US |
Postal Code: | 625264251 |
Phone Number: | 2178771100 |
Fax Number: | 2178771101 |
NPI Enumeration Date: | 04/26/2013 |
NPI Last Update Date: | 04/26/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103G00000X |
License Number: | 071004726 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
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. |