Provider Demographics
NPI:1528497559
Name:EASTON NEUROPYSCHOLOGICAL AND BEHAVIORAL SERVICES LLC
Entity type:Organization
Organization Name:EASTON NEUROPYSCHOLOGICAL AND BEHAVIORAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:
Authorized Official - Last Name:CANTWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-504-6122
Mailing Address - Street 1:299 INDUSTRIAL PARK RD
Mailing Address - Street 2:
Mailing Address - City:NAZARETH
Mailing Address - State:PA
Mailing Address - Zip Code:18064-2439
Mailing Address - Country:US
Mailing Address - Phone:610-504-6122
Mailing Address - Fax:610-365-2506
Practice Address - Street 1:299 INDUSTRIAL PARK RD
Practice Address - Street 2:
Practice Address - City:NAZARETH
Practice Address - State:PA
Practice Address - Zip Code:18064-2439
Practice Address - Country:US
Practice Address - Phone:610-504-6122
Practice Address - Fax:610-365-2506
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-12
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty