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General NPI Number Information
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NPI Number | 1881795144
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Entity Type | Organization
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Legal Business Name | BLUE RIDGE NEUROPSYCHOLOGICAL ASSOCIATES, P.A.
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 10/03/2022
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Provider Practice Location Address
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Address Line | 6 HERMAN AVENUE EXT SUITE A
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City | ASHEVILLE
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State | NC
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Zip | 28803-9106
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Country | US
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Telephone | 828-684-9123
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Fax |
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Provider Business Mailing Address
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Address Line | 6 HERMAN AVENUE EXT SUITE A
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City | ASHEVILLE
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State | NC
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Zip | 28803-9106
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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 | OWNER/PRESIDENT
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Name | MARK RANDOLPH HILL
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Credential | PH.D.
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Telephone | 828-684-9123
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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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