| NPI | 1588406177 |
|---|---|
| Doing Business As | NEUROEVOLVE INTEGRATIVE HEALTH |
| Entity Type | Organization |
| Authorized Contact | SAMANTHA D WILSON CFO 760-616-9311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-06-12 |
| Last Update Date | 2024-11-06 |