Organization
CAPITAL CITY NEUROPSYCHOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRANDON LARS ROBERG PH.D. (CLINICAL NEUROPSYCHOLOGIST)
(803) 708-7095
Entity
Organization
Contact information
Practice address
6000 GARNERS FERRY RD STE 12, COLUMBIA, SC 29209-1303
(803) 790-7095
Mailing address
6000 GARNERS FERRY RD STE 12, COLUMBIA, SC 29209-1303
(803) 708-7095
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
—
—
Other
Enumeration date
02/16/2019
Last updated
01/18/2022
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