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General NPI Number Information
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NPI Number | 1093896318
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Entity Type | Individual
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Provider Name | DAVID EDWIN STETSON PHD, PSYCHOL
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Gender | Male
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1615 S 1ST AVE
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City | SAFFORD
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State | AZ
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Zip | 85546-2103
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Country | US
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Telephone | 928-428-4550
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Fax | 928-428-4588
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Provider Business Mailing Address
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Address Line | 489 N ARROYO BLVD
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City | NOGALES
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State | AZ
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Zip | 85621-2644
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Country | US
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Telephone | 520-287-4713
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Fax | 520-287-9794
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0402X
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Taxonomy Name | Neurology with Special Qualifications in Child Neurology Physician
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License Number | PSYCHOL 3521
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License Number State | AZ
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