Healthcare Provider Details

I. General information

NPI: 1770587032
Provider Name (Legal Business Name): DONNA S. STECKAL PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2005
Last Update Date: 03/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

616 S BEELINE HWY STE 107
PAYSON AZ
85541-5380
US

IV. Provider business mailing address

PO BOX 2204 616 S BEELINE HWY STE 107
PAYSON AZ
85547-2204
US

V. Phone/Fax

Practice location:
  • Phone: 928-474-4452
  • Fax: 928-474-4898
Mailing address:
  • Phone: 928-474-4452
  • Fax: 928-474-4898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number3131
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: