Organization
PEDIATRIC NEUROPSYCHOLOGICAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAWN H HUBER PHD (MANAGING MEMBER)
(417) 753-1963
Entity
Organization
Contact information
Practice address
175 S. MARSHALL, SUITE G, ROGERSVILLE, MO 65742
(417) 753-1963
(417) 753-9405
Mailing address
175 S. MARSHALL, SUITE G, ROGERSVILLE, MO 65742
(417) 753-1963
(417) 753-9405
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
2008011433
MO
103T00000X
Psychologist
Primary
2008011433
MO
103TB0200X
Cognitive & Behavioral Psychologist
2008011433
MO
103TC2200X
Clinical Child & Adolescent Psychologist
2008011433
MO
103TH0004X
Health Psychologist
2008011433
MO
103TM1800X
Intellectual & Developmental Disabilities Psychologist
2008011433
MO
Other
Enumeration date
08/29/2012
Last updated
08/29/2012
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