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86 W Sunbridge Dr Fayetteville AR 72703-1822 | |
| (479) 587-8921 | |
| (479) 587-9024 |
| Full Name | |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 86 W Sunbridge Dr, Fayetteville, Arkansas |
| Authorized Official Name and Position | Anne W Stevens (OWNER) |
| Authorized Official Contact | 4795878921 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
86 W Sunbridge Dr Fayetteville AR 72703-1822 Ph: (479) 587-8921 | 86 W Sunbridge Dr Fayetteville AR 72703-1822 Ph: (479) 587-8921 |
| NPI Number | 1215062369 |
|---|---|
| Provider Enumeration Date | 02/22/2007 |
| Last Update Date | 09/19/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215062369 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | (* (Not Available)) | Primary |
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Secondary |
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