| NPI | 1235337528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY L. LANGE Clinical Neuropsychologist 858-218-4601 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: CA 21401) |
| Enumeration Date | 2007-07-07 |
| Last Update Date | 2020-08-22 |