| NPI | 1043814874 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY A MARTIELLI Neuropsychologist/Member 314-324-3800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist |
| Additional Taxonomies | 103TC0700X Psychologist Clinical |
| Enumeration Date | 2020-11-23 |
| Last Update Date | 2020-11-23 |