Provider Demographics
NPI:1588846711
Name:CENTER FOR NEUROBEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:CENTER FOR NEUROBEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/CLINICAL NEUROPSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:RILLING
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:972-731-6985
Mailing Address - Street 1:5700 GRANITE PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-6622
Mailing Address - Country:US
Mailing Address - Phone:972-731-6985
Mailing Address - Fax:972-731-6986
Practice Address - Street 1:5700 GRANITE PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-6622
Practice Address - Country:US
Practice Address - Phone:972-731-6985
Practice Address - Fax:972-731-6986
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-29
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33537103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty