MEDICARE: NEUROBEHAVIORAL ASSOCIATES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103G00000X	Clinical Neuropsychologist

General Provider Information

NPI Number	:	1821323106
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEUROBEHAVIORAL ASSOCIATES

Provider Business Mailing Address
First Line	:	5565 STERRETT PL
Second Line	:	SUITE 320
City	:	COLUMBIA
State	:	MD
Zip	:	21044-2665
Country	:	US
Telephone Number	:	410-772-7155
Fax Number	:	410-772-7156

Provider Business Practice Location Address
First Line	:	5565 STERRETT PL
Second Line	:	SUITE 320
City	:	COLUMBIA
State	:	MD
Zip	:	21044-2665
Country	:	US
Telephone Number	:	410-772-7155
Fax Number	:	410-772-7156

Authorized Official
Title or Position	:	PRESIDENT/NEUROPSYCHOLOGIST
Name	:	VINCENT P. CULOTTA
Credential	:	PH.D., ABN
Telephone Number	:	410-772-7155

Provider Enumeration Date	:	10/05/2009
Last Update Date	:	10/05/2009

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