Organization
COMPREHENSIVE NEUROBEHAVIORAL SERVICES, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON MARIE FOSTER PH.D. (PRESIDENT)
(916) 716-9105
Entity
Organization
Contact information
Practice address
2142 ALT 19, STE C1, PALM HARBOR, FL 34683-5361
(916) 716-9105
Mailing address
2142 ALT 19, STE C1, PALM HARBOR, FL 34683-5361
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PY 9339
FL
103TA0700X
Adult Development & Aging Psychologist
PY 9339
FL
103TC0700X
Clinical Psychologist
PY 9339
FL
Other
Enumeration date
01/23/2016
Last updated
01/23/2016
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