| NPI | 1275162281 |
|---|---|
| Former Legal Business Name | BLACK SAND NEUROPSYCHOLOGICAL SERVICES, PC |
| Entity Type | Organization |
| Authorized Contact | LORRAINE RAZZI FREEDLE President 808-345-1726 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist |
| Enumeration Date | 2020-04-02 |
| Last Update Date | 2020-04-02 |