| NPI | 1649478744 |
|---|---|
| Doing Business As | FORT WAYNE NEUROPSYCHOLOGY |
| Entity Type | Organization |
| Authorized Contact | W BARRY KUNKLE CEO 260-399-4704 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist |
| Additional Taxonomies | 103T00000X Psychologist |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2015-01-28 |