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General NPI Number Information
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NPI Number | 1326169277
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Entity Type | Organization
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Legal Business Name | THE CENTER FOR NEUROPSYCHOLOGY & LEARNING DISORDERS INC
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 512 MAIN ST
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City | WAKEFIELD
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State | RI
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Zip | 02879
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Country | US
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Telephone | 401-789-7848
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 69
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City | WAKEFIELD
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State | RI
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Zip | 02880
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Country | US
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Telephone | 401-789-7848
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Fax |
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Authorized Official
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Title or Position | PRACTICE ADMIN CO OWNER
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Name | PATRICIA A FITZMAURICE
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Credential |
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Telephone | 401-789-7848
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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 |
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License Number State |
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