| NPI | 1104282664 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDY ANN KOSTERS Business Office Director 870-845-8024 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: AR E-5611) |
| Enumeration Date | 2016-01-13 |
| Last Update Date | 2016-01-13 |