| NPI | 1982120325 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICK STEPHAN Neuropsychologist 202-297-0670 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: FL PY9528) |
| Additional Taxonomies | 103TR0400X Psychologist, Rehabilitation (Licence: FL PY9528) |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: FL PY9528) | |
| 103TA0700X Psychologist, Adult Development & Aging (Licence: FL PY9528) | |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: FL PY9528) | |
| 103TF0200X Psychologist, Forensic (Licence: FL PY9528) | |
| 103TH0004X Psychologist, Health (Licence: FL PY9528) | |
| Enumeration Date | 2017-08-17 |
| Last Update Date | 2022-07-21 |