| NPI | 1164765095 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICKEYA D CROPPER Credentialing/Payor Specialist 410-933-3033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist |
| Enumeration Date | 2013-03-28 |
| Last Update Date | 2013-03-28 |