Provider Demographics
NPI:1023721511
Name:CNLD NEUROPSYCHOLOGY PC
Entity type:Organization
Organization Name:CNLD NEUROPSYCHOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:E
Authorized Official - Last Name:LAUER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:734-994-9466
Mailing Address - Street 1:5864 INTERFACE DR STE D
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-9514
Mailing Address - Country:US
Mailing Address - Phone:734-994-9466
Mailing Address - Fax:734-994-9465
Practice Address - Street 1:5864 INTERFACE DR STE D
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-9514
Practice Address - Country:US
Practice Address - Phone:734-994-9466
Practice Address - Fax:734-994-9465
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTER FOR NEUROPSYCHOLOGY & LEARNING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-12-30
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty