NPI 1255697330 · live from the CMS NPI Registry
Conway Psychological Assessment Center
Psychologist in Conway, AR. National Provider Identifier 1255697330, active.
NPI record
| NPI | 1255697330 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Psychologist 103T00000X |
| Practice location | 1210 Hogan Ln, Suite 200, Conway, AR 72034 |
| Practice phone | 501-932-0255 |
| Enumerated | April 3, 2012 |
| Last updated | April 3, 2012 |
| Authorized official | Kim Dielmann, Clinical Director |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychologist primary | 103T00000X | 07-27P (AR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.