| NPI | 1417197666 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY CHARLES STEVENS President 928-779-3783 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TH0004X Psychologist, Health (Licence: AZ 1177) |
| Enumeration Date | 2009-03-01 |
| Last Update Date | 2009-03-01 |