NPI | 1629411319 |
---|---|
Doing Business As | MEDICAL PSYCHOLOGY ASSOCIATES |
Entity Type | Organization |
Authorized Contact | SCOTT DEVERE WYLIE Owner 888-666-0974 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: CO 2962) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: CO 2962) |
103TC0700X Psychologist, Clinical (Licence: CO 2962) | |
103TP0016X Psychologist, Prescribing (Medical) (Licence: CO 2962) | |
Enumeration Date | 2013-04-11 |
Last Update Date | 2018-04-07 |