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
Fax: (480) 926-0645
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497063424 NPPES
Arizona MEDICAID 644018

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