Doctor Name: | DR. EDWARD EUGENE STAMBAUGH |
NPI Number: | 1043546674 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | 2066 |
Business Practice Address: | 1912 Lookout Dr Windsor, CO - 805504633 |
Business Phone Number: | 9706910285 |
Business Fax Number: | |
Mailing Address: | 1912 Lookout Dr, WINDSOR |
State: | CO |
Postal Code: | 805504633 |
Phone Number: | 9706910285 |
Fax Number: | |
NPI Enumeration Date: | 11/02/2009 |
NPI Last Update Date: | 11/02/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 2066 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |