| NPI | 1225840622 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA J STOCK Owner 720-607-1867 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 246ZE0500X Specialist/Technologist, Other, EEG |
| 247200000X Technician, Other | |
| Enumeration Date | 2025-01-22 |
| Last Update Date | 2025-01-22 |