| Neuropsychology & Memory Center, P.a. | |
|
4521 Executive Dr Suite # 204 Naples FL 34119-9037 | |
| (239) 592-1771 | |
| (239) 592-0258 |
| Full Name | Neuropsychology & Memory Center, P.a. |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 4521 Executive Dr, Naples, Florida |
| Authorized Official Name and Position | Jody E. Talbott (OWNER PRESIDENT) |
| Authorized Official Contact | 2395921771 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neuropsychology & Memory Center, P.a. 4521 Executive Dr Suite # 204 Naples FL 34119-9037 Ph: (239) 592-1771 | Neuropsychology & Memory Center, P.a. 4521 Executive Dr Suite # 204 Naples FL 34119-9037 Ph: (239) 592-1771 |
| NPI Number | 1619902103 |
|---|---|
| Provider Enumeration Date | 07/12/2006 |
| Last Update Date | 05/19/2011 |
| Medicare PECOS PAC ID | 7618074550 |
|---|---|
| Medicare Enrollment ID | O20070529000530 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619902103 | NPI | - | NPPES |
| U4063Y | Other | FL | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | PY 7020 (Florida) | Primary |
| Provider Name | Jody E Talbott |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1861475659 PECOS PAC ID: 8628027992 Enrollment ID: I20050113001038 |
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