| Florida Neurocognitive Development Center | |
|
3815 Maryweather Ln Suite 101 Wesley Chapel FL 33544-7792 | |
| (813) 399-1625 | |
| (813) 873-8837 |
| Full Name | Florida Neurocognitive Development Center |
|---|---|
| Speciality | Psychologist - Clinical Child & Adolescent |
| Location | 3815 Maryweather Ln, Wesley Chapel, Florida |
| Authorized Official Name and Position | Diane Abby Koch (PRESIDENT) |
| Authorized Official Contact | 8133991625 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Florida Neurocognitive Development Center 3815 Maryweather Ln Suite 101 Wesley Chapel FL 33544-7792 Ph: (813) 399-1625 | Florida Neurocognitive Development Center 3815 Maryweather Ln Suite 101 Wesley Chapel FL 33544-7792 Ph: (813) 399-1625 |
| NPI Number | 1013295450 |
|---|---|
| Provider Enumeration Date | 08/03/2011 |
| Last Update Date | 08/03/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013295450 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC2200X | Psychologist - Clinical Child & Adolescent | PY4230 (Florida) | Primary |
| 235Z00000X | Speech-language Pathologist | SA3850 (Florida) | Secondary |
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