Provider Demographics
NPI:1215563887
Name:DR CLOYD'S CLINICAL PSYCHOLOGY AND NEUROPSYCHOLOGY PRACTICE PLLC
Entity Type:Organization
Organization Name:DR CLOYD'S CLINICAL PSYCHOLOGY AND NEUROPSYCHOLOGY PRACTICE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL/NEURO PSCHOLOGIST/MANAGER/
Authorized Official - Prefix:
Authorized Official - First Name:CARTER
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:CLOYD
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:215-990-7714
Mailing Address - Street 1:529 KINGSLEY CT
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19128-2719
Mailing Address - Country:US
Mailing Address - Phone:215-990-7714
Mailing Address - Fax:856-428-4050
Practice Address - Street 1:1209 ROUTE 70 W
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-3532
Practice Address - Country:US
Practice Address - Phone:215-990-7714
Practice Address - Fax:856-428-4050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-16
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center