| NPI | 1740579069 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAN A JOHNSON Clinical Neuropsychologist; Owner 870-933-5174 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: AR 09-61AE) |
| Enumeration Date | 2011-04-07 |
| Last Update Date | 2011-04-07 |