Provider Demographics
NPI:1699241513
Name:NEURO PSYCHIATRIC & BEHAVIORAL REHABILITATION PRACTITIONERS ASSOCIATIO
Entity type:Organization
Organization Name:NEURO PSYCHIATRIC & BEHAVIORAL REHABILITATION PRACTITIONERS ASSOCIATIO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NEUROPSYCH REHAB PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHANEQUIA
Authorized Official - Middle Name:DESHAWN
Authorized Official - Last Name:CLEMONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-826-0080
Mailing Address - Street 1:534 HUNT LN
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78245-2333
Mailing Address - Country:US
Mailing Address - Phone:210-606-2319
Mailing Address - Fax:
Practice Address - Street 1:534 HUNT LN
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78245-2333
Practice Address - Country:US
Practice Address - Phone:210-606-2319
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-18
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084B0040XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBehavioral Neurology & NeuropsychiatryGroup - Multi-Specialty