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General NPI Number Information
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NPI Number | 1659166536
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Entity Type | Organization
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Legal Business Name | DR. SHANNON STUART-MAVER PSYCHOLOGICAL SERVICES, APC
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Dates
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Enumeration Date | 04/11/2025
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Last Update Date | 04/11/2025
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Provider Practice Location Address
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Address Line | 1977 LESLIE CT
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City | ARCATA
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State | CA
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Zip | 95521-4754
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Country | US
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Telephone | 707-840-4668
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Fax | 707-388-3036
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Provider Business Mailing Address
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Address Line | PO BOX 10
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City | ARCATA
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State | CA
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Zip | 95518-0010
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Country | US
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Telephone | 707-840-4668
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Fax | 707-388-3036
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Authorized Official
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Title or Position | OWNER
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Name | DR. SHANNON LEIGH STUART-MAVER
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Credential | PHD
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Telephone | 707-840-4668
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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 |
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License Number State |
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