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General NPI Number Information
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NPI Number | 1881613743
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Entity Type | Organization
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Legal Business Name | NEUROPSYCHOLOGICAL ASSOCIATES OF SOUTH FLORIDA PA
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 09/20/2007
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Provider Practice Location Address
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Address Line | 12600 CREEKSIDE LN STE 7A
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City | FORT MYERS
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State | FL
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Zip | 33919-3353
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Country | US
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Telephone | 239-481-1633
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Fax | 293-481-1632
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Provider Business Mailing Address
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Address Line | 12600 CREEKSIDE LN STE 7A
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City | FORT MYERS
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State | FL
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Zip | 33919-3353
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Country | US
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Telephone | 239-481-1633
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Fax | 293-481-1632
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST NEUROPSYCHOL
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Name | DR. STEPHEN PATRICK SCHENGBER
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Credential | PSY D
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Telephone | 239-481-1633
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY 6116
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License Number State | FL
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