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General NPI Number Information
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NPI Number | 1245448216
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Entity Type | Individual
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Provider Name | STEPHEN ANTHONY DEAN PHD
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Gender | Male
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 05/17/2023
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Provider Practice Location Address
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Address Line | 1369 MARKET AVE N
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City | CANTON
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State | OH
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Zip | 44714-2611
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Country | US
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Telephone | 330-455-2145
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Fax | 330-455-0131
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Provider Business Mailing Address
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Address Line | 1369 MARKET AVE N
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City | CANTON
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State | OH
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Zip | 44714-2611
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Country | US
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Telephone | 330-455-2145
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Fax | 330-455-0131
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 5186
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License Number State | OH
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