Provider Demographics
NPI:1821323106
Name:NEUROBEHAVIORAL ASSOCIATES
Entity Type:Organization
Organization Name:NEUROBEHAVIORAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/NEUROPSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:P
Authorized Official - Last Name:CULOTTA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, ABN
Authorized Official - Phone:410-772-7155
Mailing Address - Street 1:5565 STERRETT PL
Mailing Address - Street 2:SUITE 320
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-2665
Mailing Address - Country:US
Mailing Address - Phone:410-772-7155
Mailing Address - Fax:410-772-7156
Practice Address - Street 1:5565 STERRETT PL
Practice Address - Street 2:SUITE 320
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-2665
Practice Address - Country:US
Practice Address - Phone:410-772-7155
Practice Address - Fax:410-772-7156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-05
Last Update Date:2009-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty