Organization
NEUROBEHAVIORAL DIAGNOSTICS LLC
Active
Organization
NEUROBEHAVIORAL DIAGNOSTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIMBERLY KRUSE (MANAGER)
(803) 434-4838
Entity
Organization
Contact information
Practice address
11 RICHLAND MEDICAL PARK DR, COLUMBIA, SC 29203-6863
(803) 434-4838
Mailing address
143 ISLAND VIEW CIR, ELGIN, SC 29045-9182
(803) 434-4838
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1158
SC
Other
Enumeration date
06/10/2014
Last updated
06/19/2014
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