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NPI Code Detail

MEDICARE: COLLEGE PARK NEUROPSYCHOLOGY

MEDICARE: COLLEGE PARK NEUROPSYCHOLOGY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0850XAdult Mental Health Clinic/Center00995IA

General Provider Information

NPI Number : 1881103471
Entity Type Code : Organization
Provider Name (Legal Business Name) : COLLEGE PARK NEUROPSYCHOLOGY
Provider Business Mailing Address
First Line : 700 16TH ST NE STE 201
Second Line :
City : CEDAR RAPIDS
State : IA
Zip : 52402-4665
Country : US
Telephone Number : 319-365-3935
Fax Number : 319-363-3448
Provider Business Practice Location Address
First Line : 700 16TH ST NE STE 201
Second Line :
City : CEDAR RAPIDS
State : IA
Zip : 52402-4665
Country : US
Telephone Number : 319-365-3935
Fax Number : 319-363-3448
Authorized Official
Title or Position : OWNER
Name : DR. ANGELA D PERKINS
Credential : PSYD
Telephone Number : 319-363-3935
Provider Enumeration Date : 09/26/2017
Last Update Date : 07/21/2022

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Directions to “COLLEGE PARK NEUROPSYCHOLOGY ” Practice Location

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