Doctor Name: | DR. LAURA BRUDER WEINBERG |
NPI Number: | 1902213960 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | PSY1000931 |
Business Practice Address: | 102 Irving St Nw Washington, DC - 200102921 |
Business Phone Number: | 2028771128 |
Business Fax Number: | |
Mailing Address: | 2900 Corporate Way D, MIRAMAR |
State: | FL |
Postal Code: | 330253925 |
Phone Number: | 9542765572 |
Fax Number: | 9549857049 |
NPI Enumeration Date: | 07/22/2014 |
NPI Last Update Date: | 10/15/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103G00000X |
License Number: | PSY1000931 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | DC |
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. |