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General NPI Number Information
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NPI Number | 1356166300
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Entity Type | Individual
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Provider Name | STEPHEN PAUL CASE PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 11/15/2024
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Last Update Date | 11/15/2024
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Provider Practice Location Address
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Address Line | 209 SPEIGHT AVE
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City | WACO
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State | TX
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Zip | 76706-1507
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Country | US
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Telephone | 254-710-2467
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Fax |
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Provider Business Mailing Address
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Address Line | 8206 WOODCREEK DR
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City | WOODWAY
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State | TX
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Zip | 76712-3509
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Country | US
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Telephone | 979-492-9053
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Fax |
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 38549
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License Number State | TX
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