NPI | 1720316755 |
---|---|
Entity Type | Organization |
Authorized Contact | STEPHANIE RENEE JOHNSON Owner 202-903-4763 |
Organization Subpart ? | No |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: DC 1000591) |
Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
261QP2300X Clinic/Center, Primary Care | |
Enumeration Date | 2009-12-02 |
Last Update Date | 2024-05-20 |