| Dakota Trauma Therapy And Neuropsychology Pllc | |
|
311 N Mandan St # 1 Bismarck ND 58501-3859 | |
| (701) 415-6745 | |
| Not Available |
| Full Name | Dakota Trauma Therapy And Neuropsychology Pllc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 311 N Mandan St # 1, Bismarck, North Dakota |
| Authorized Official Name and Position | David Brooks (OWNER) |
| Authorized Official Contact | 7014156745 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dakota Trauma Therapy And Neuropsychology Pllc 311 N Mandan St # 1 Bismarck ND 58501-3859 Ph: (701) 415-6745 | Dakota Trauma Therapy And Neuropsychology Pllc 311 N Mandan St # 1 Bismarck ND 58501-3859 Ph: (701) 415-6745 |
| NPI Number | 1316541790 |
|---|---|
| Provider Enumeration Date | 11/25/2020 |
| Last Update Date | 11/25/2020 |
| Certification Date | 11/25/2020 |
| Medicare PECOS PAC ID | 1254744055 |
|---|---|
| Medicare Enrollment ID | O20210118000223 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316541790 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | (* (Not Available)) | Primary |
| 103T00000X | Psychologist | (* (Not Available)) | Secondary |
| Provider Name | David Brooks |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1790839934 PECOS PAC ID: 7012031842 Enrollment ID: I20100901000171 |
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