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General NPI Number Information
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NPI Number | 1013059187
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Entity Type | Organization
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Legal Business Name | NEUROPSYCHOLOGICAL CONSULTANTS INC
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 11/10/2023
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Provider Practice Location Address
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Address Line | 5017 GREEN BAY RD STE 130
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City | KENOSHA
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State | WI
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Zip | 53144-1782
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Country | US
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Telephone | 262-671-1334
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Fax |
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Provider Business Mailing Address
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Address Line | 5017 GREEN BAY RD STE 130
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City | KENOSHA
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State | WI
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Zip | 53144-1782
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Country | US
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Telephone | 262-671-1334
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TERESA M. D DEER
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Credential | PH.D.
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Telephone | 847-308-6125
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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