Provider Demographics
NPI:1306213996
Name:POSITIVE NEUROPSYCHOLOGY PLLC
Entity Type:Organization
Organization Name:POSITIVE NEUROPSYCHOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSCH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD,LP
Authorized Official - Phone:866-427-0850
Mailing Address - Street 1:3507 W 50TH ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55410-2124
Mailing Address - Country:US
Mailing Address - Phone:866-427-0850
Mailing Address - Fax:
Practice Address - Street 1:3507 W 50TH ST
Practice Address - Street 2:SUITE 2
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55410-2124
Practice Address - Country:US
Practice Address - Phone:866-427-0850
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-31
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP4410103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty