| NPI | 1265764278 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HAROLD DANIEL BLACKWOOD Presicent 6022-308-3224 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: AZ 689) |
| Enumeration Date | 2010-02-02 |
| Last Update Date | 2010-02-02 |