| NPI | 1992850606 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES M FUENDELING Office Manager 479-422-4489 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: AR 01-15P) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: AR 01-15P) |
| 103TC1900X Psychologist, Counseling (Licence: AR 01-05P) | |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2012-09-20 |