Organization
DEVELOPMENTAL NEUROPSYCHOLOGICAL SERVICES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD EDWARDS PH.D. (OWNER/PRESIDENT)
(574) 855-7169
Entity
Organization
Contact information
Practice address
3608 PLEASANT ST, SOUTH BEND, IN 46615-2033
(574) 367-2371
Mailing address
3608 PLEASANT ST, SOUTH BEND, IN 46615-2033
(574) 367-2371
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
20042553A
IN
103TB0200X
Cognitive & Behavioral Psychologist
20042553A
IN
103TC0700X
Clinical Psychologist
20042553A
IN
103TC2200X
Clinical Child & Adolescent Psychologist
20042553A
IN
Other
Enumeration date
06/25/2015
Last updated
06/25/2015
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