Organization
TIDAL NEUROPSYCHOLOGY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GRIFFIN POLLOCK SUTTON PH.D. (OWNER, MEMBER)
(910) 803-1434
Entity
Organization
Contact information
Practice address
19 S HAMPSTEAD VILLAGE DR, HAMPSTEAD, NC 28443-3934
(910) 803-1434
(855) 672-7002
Mailing address
PO BOX 970, HAMPSTEAD, NC 28443-0970
(910) 803-1434
(855) 672-7002
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
4633
NC
103TC0700X
Clinical Psychologist
4633
NC
Other
Enumeration date
11/07/2014
Last updated
11/07/2014
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