Individual provider · Type 1 NPI
Johnathan Vital, PhD
Clinical Neuropsychologist · Waldorf, MD
Practice location
2413 Altenburg Ct
Waldorf, MD 20603
Fax (202) 558-7113
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Clinical Neuropsychologist Primary | 103G00000X | 04759 (MD) |
| Psychologist | 103T00000X | 04759 (MD) |
| Clinical Neuropsychologist | 103G00000X | PSY1000614 (DC) |
| Psychologist | 103T00000X | PSY1000614 (DC) |
Clinical Neuropsychologist: A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems.
About NPI 1477810067
Johnathan Vital, PhD's National Provider Identifier is 1477810067, issued on Apr 19, 2012. The primary taxonomy on file is Clinical Neuropsychologist (103G00000X), and the practice location is in Waldorf, MD. The record was last updated on Apr 20, 2012.