| NPI | 1679302608 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL RIVERS Member/ Clinical Neuropsychologist 919-357-8006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist |
| Additional Taxonomies | 103TC0700X Psychologist Clinical |
| 103TH0100X Psychologist Health Service | |
| Enumeration Date | 2024-07-29 |
| Last Update Date | 2024-07-29 |