# FLORIDA NEUROCOGNITIVE DEVELOPMENT CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013295450
- **Authorized official:** DR. DIANE ABBY KOCH PH.D. (PRESIDENT)
- **Authorized official phone:** (813) 399-1625

## Contact information

- **Practice address:** 3815 MARYWEATHER LN, SUITE 101, WESLEY CHAPEL, FL 33544-7792
- **Practice address phone:** (813) 399-1625
- **Practice address fax:** (813) 873-8837
- **Mailing address:** 3815 MARYWEATHER LN, SUITE 101, WESLEY CHAPEL, FL 33544-7792
- **Mailing address phone:** (813) 399-1625
- **Mailing address fax:** (813) 873-8837

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TC2200X | Clinical Child & Adolescent Psychologist | PY4230 | FL | Yes |
| 235Z00000X | Speech-Language Pathologist | SA3850 | FL | — |

## Other

- **Enumeration date:** 08/03/2011
- **Last updated:** 08/03/2011