Provider Demographics
NPI:1659549434
Name:NEUROPSYCHOLOGICAL AND PSYCHOLOGICAL SERVICES CORPORATION
Entity Type:Organization
Organization Name:NEUROPSYCHOLOGICAL AND PSYCHOLOGICAL SERVICES CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:
Authorized Official - Last Name:ANIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-680-4211
Mailing Address - Street 1:PO BOX 71973
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84171-0973
Mailing Address - Country:US
Mailing Address - Phone:801-680-4211
Mailing Address - Fax:
Practice Address - Street 1:1002 E SOUTH TEMPLE
Practice Address - Street 2:SUITE 207
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84102-1525
Practice Address - Country:US
Practice Address - Phone:801-680-4211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-14
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT3395102501103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty