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General NPI Number Information
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NPI Number | 1417240615
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Entity Type | Organization
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Legal Business Name | CENTER FOR NEUROPSYCHOLOGICAL SERVICES LLC
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Dates
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Enumeration Date | 05/20/2011
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Last Update Date | 05/20/2011
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Provider Practice Location Address
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Address Line | 1150 COLONY DR
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City | WESTERVILLE
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State | OH
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Zip | 43081-3624
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Country | US
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Telephone | 614-891-5055
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2985
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City | WESTERVILLE
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State | OH
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Zip | 43086-2985
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | NEUROPSYCHOLOGIST
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Name | DR. PHILIP RICHARD WHATLEY
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Credential | PH.D.
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Telephone | 614-356-0787
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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 | 6222
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License Number State | OH
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