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General NPI Number Information
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NPI Number | 1104708809
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Entity Type | Organization
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Legal Business Name | GRAND RAPIDS NEUROPSYCHOLOGY PLLC
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Dates
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Enumeration Date | 07/23/2025
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 519 COMSTOCK BLVD NE
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City | GRAND RAPIDS
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State | MI
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Zip | 49505-3642
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Country | US
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Telephone | 815-382-3123
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Fax |
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Provider Business Mailing Address
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Address Line | 519 COMSTOCK BLVD NE
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City | GRAND RAPIDS
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State | MI
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Zip | 49505-3642
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Country | US
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Telephone | 815-382-3123
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BRETT S SCHNEIDER
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Credential | PHD
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Telephone | 815-382-3123
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TA0700X
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Taxonomy Name | Adult Development & Aging Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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License Number State |
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