Organization
MIDWEST NEUROPSYCHOLOGY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN J THOMPSON PH.D. (NEUROPSYCHOLOGIST)
(701) 780-9700
Entity
Organization
Contact information
Practice address
3301 30TH AVE S STE 101, GRAND FORKS, ND 58201-6009
(701) 780-9700
(701) 780-9709
Mailing address
3301 30TH AVE S STE 101, GRAND FORKS, ND 58201-6009
(701) 780-9700
(701) 780-9709
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000015495
—
ND
01
—
N715763
MEDICARE PART B
ND
Enumeration date
12/14/2010
Last updated
04/18/2014
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