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General NPI Number Information
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NPI Number | 1083043079
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Entity Type | Organization
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Legal Business Name | NEUROPSYCHOLOGY SERVICES OF SOUTHWEST OHIO, LLC
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Dates
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Enumeration Date | 11/11/2013
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Last Update Date | 02/05/2014
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Provider Practice Location Address
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Address Line | 1 ELIZABETH PL
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City | DAYTON
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State | OH
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Zip | 45417-3445
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Country | US
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Telephone | 937-424-8306
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Fax | 937-222-7726
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Provider Business Mailing Address
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Address Line | 4954 WALNUT WALK
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City | KETTERING
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State | OH
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Zip | 45429-1936
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Country | US
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Telephone | 847-421-6323
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Fax | 937-395-8139
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Authorized Official
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Title or Position | OWNER
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Name | DR. NICHOLAS DONINGER
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Credential | PHD
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Telephone | 847-421-6323
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 6061
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License Number State | OH
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