| NPI | 1457711251 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL D PELLA Owner 210-309-5124 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: OK 1248) |
| Enumeration Date | 2016-03-07 |
| Last Update Date | 2016-03-07 |