Provider Demographics
NPI:1043988140
Name:INSTITUTUE ON NEUROPLASTICITY, LLC
Entity Type:Organization
Organization Name:INSTITUTUE ON NEUROPLASTICITY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HEINRICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-385-1914
Mailing Address - Street 1:1001 WEST LOOP S STE 635
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-9077
Mailing Address - Country:US
Mailing Address - Phone:713-385-1914
Mailing Address - Fax:
Practice Address - Street 1:1001 WEST LOOP S STE 560
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-9069
Practice Address - Country:US
Practice Address - Phone:713-385-1914
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-02
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health