Organization
TWO RIVERS NEUROPSYCHOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRYSTAL RIVERS PHD, LP (MEMBER/ CLINICAL NEUROPSYCHOLOGIST)
(515) 220-2747
Entity
Organization
Contact information
Practice address
4700 78TH ST, URBANDALE, IA 50322-1031
(919) 357-8006
Mailing address
4700 78TH ST, URBANDALE, IA 50322-1031
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
—
—
103TC0700X
Clinical Psychologist
—
—
103TH0100X
Health Service Psychologist
—
—
Other
Enumeration date
07/29/2024
Last updated
02/18/2025
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