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General NPI Number Information
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NPI Number | 1346431434
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Entity Type | Organization
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Legal Business Name | NEUROSCIENCE AND BEHAVIORAL HEALTH ASSOCIATES
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Dates
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Enumeration Date | 08/05/2007
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Last Update Date | 08/05/2007
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Provider Practice Location Address
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Address Line | 503 CENTRE VIEW BLVD
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City | CRESTVIEW HILLS
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State | KY
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Zip | 41017-3444
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Country | US
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Telephone | 859-426-7800
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Fax | 859-426-7804
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Provider Business Mailing Address
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Address Line | 503 CENTRE VIEW BLVD
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City | CRESTVIEW HILLS
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State | KY
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Zip | 41017-3444
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Country | US
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Telephone | 859-426-7800
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Fax | 859-426-7804
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Authorized Official
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Title or Position | NEUROPSYCHOLOGIST
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Name | DR. DANIEL GRIPSHOVER
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Credential | PH.D.
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Telephone | 859-426-7800
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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 | KY-1153
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License Number State | KY
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