| NPI | 1194028555 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA SUE WEITZEL Owner 228-385-7733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MS 45-725) |
| Enumeration Date | 2010-12-07 |
| Last Update Date | 2010-12-07 |