Great Lakes Neuropsychology & Counseling Llc

NPI 1013030725 - Clinical Neuropsychologist - 103G00000X

NPI Details
NPI 1013030725
Enumeration Date 04/09/2007
Last Updated 02/05/2008
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name SHAUN A SHAUN
Position LICENSED CLINICAL PSYCHOLOGIST/MEMB
Phone (815) 231-1280
Fax (815) 231-1282
Practice Location
5758 ELAINE DR
ROCKFORD IL, 61108-3102, US
Phone (815) 231-1280
Fax (815) 231-1282
Business Location
5758 ELAINE DR
ROCKFORD IL, 61108-3102, US
Phone (815) 231-1280
Fax (815) 231-1282
Toxanomy
Taxonomy Code 103G00000X
License State
License Number
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According to our database, Great Lakes Neuropsychology & Counseling Llc NPI is 1013030725, taxonomy code is 103G00000X Great Lakes Neuropsychology & Counseling Llc physically located at 5758 Elaine Dr, Rockford IL, 61108-3102. NPI Number 1033115704 has the healthcare provider type.

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1013030725 NPI number is provided on an as is basis without warranty of any kind. 1013030725 is maintained by the National Plan & Provider Enumeration System. The contents of Great Lakes Neuropsychology & Counseling Llc are for informational purposes only.