Etling, Theodore Webster
Etling, Theodore Webster is an individual health care provider with primary practice located at 7400 S Power Rd Ste 120 , Gilbert AZ 85297-9283. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Neuropsychologist, which is considered as his primary health care specialty. Etling, Theodore Webster can be contacted via phone (480) 926-0644.Contact Information
Primary practice address
7400 S Power Rd Ste 120
Gilbert AZ 85297-9283
Phone: (480) 926-0644
Fax: (480) 926-0645
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Clinical Neuropsychologist | 103G00000X | 4204 | Arizona |
Profile Details
NPI number | 1497063424 |
---|---|
LBN Legal business name | Etling, Theodore Webster |
Credentials | PSYD |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Sep 24th, 2010 |
Last updated | Oct 17th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1497063424 | NPPES |
Arizona | MEDICAID | 644018 |
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