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General NPI Number Information
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NPI Number | 1609267475
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Entity Type | Organization
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Legal Business Name | STEPHEN C. LOTT, PSY.D. LLC
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Dates
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Enumeration Date | 02/13/2015
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Last Update Date | 02/13/2015
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Provider Practice Location Address
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Address Line | 105 E GREGORY SQ SUITE G
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City | PENSACOLA
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State | FL
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Zip | 32502-4971
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Country | US
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Telephone | 850-764-5431
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Fax | 850-659-2159
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Provider Business Mailing Address
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Address Line | 105 E GREGORY SQ SUITE G
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City | PENSACOLA
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State | FL
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Zip | 32502-4971
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Country | US
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Telephone | 850-764-5431
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Fax | 850-659-2159
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. STEPHEN C. LOTT
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Credential | PSY.D.
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Telephone | 850-764-5431
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | PY4497
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License Number State | FL
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