| Gulf Coast Neuropsychology And Neuro-rehabilitation | |
|
8837 Lorraine Rd Ste B Gulfport MS 39503-5081 | |
| (228) 465-2524 | |
| Not Available |
| Full Name | Gulf Coast Neuropsychology And Neuro-rehabilitation |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 8837 Lorraine Rd Ste B, Gulfport, Mississippi |
| Authorized Official Name and Position | Racha Fares (NEUROPSYCHOLOGIST) |
| Authorized Official Contact | 2284652524 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gulf Coast Neuropsychology And Neuro-rehabilitation 14612 Porteaux Bay Dr Biloxi MS 39532-7327 Ph: (321) 432-4722 | Gulf Coast Neuropsychology And Neuro-rehabilitation 8837 Lorraine Rd Ste B Gulfport MS 39503-5081 Ph: (228) 465-2524 |
| NPI Number | 1396472411 |
|---|---|
| Provider Enumeration Date | 08/08/2022 |
| Last Update Date | 08/08/2022 |
| Certification Date | 08/08/2022 |
| Medicare PECOS PAC ID | 5092191221 |
|---|---|
| Medicare Enrollment ID | O20220926002091 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396472411 | NPI | - | NPPES |
| Provider Name | Racha Fares |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1952727430 PECOS PAC ID: 6103202346 Enrollment ID: I20220926002453 |
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