| Stillwater Center For Family Therapy | |
|
158 S Taylor St Fallon NV 89406-3261 | |
| (775) 867-4123 | |
| (775) 867-4914 |
| Full Name | Stillwater Center For Family Therapy |
|---|---|
| Speciality | Psychologist |
| Location | 158 S Taylor St, Fallon, Nevada |
| Authorized Official Name and Position | Carol Juul (LICXENSED CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 7758674123 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Stillwater Center For Family Therapy Po Box 370 Fallon NV 89407-0370 Ph: (775) 867-4123 | Stillwater Center For Family Therapy 158 S Taylor St Fallon NV 89406-3261 Ph: (775) 867-4123 |
| NPI Number | 1760644041 |
|---|---|
| Provider Enumeration Date | 06/27/2008 |
| Last Update Date | 06/27/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760644041 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PY0436 (Nevada) | Primary |
| 1041C0700X | Social Worker - Clinical | 2940-C (Nevada) | Secondary |
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