Doctor Name: | DR. FOREST TU PAVEL |
NPI Number: | 1053601724 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PSY.D. |
License Number: | 6192 |
Business Practice Address: | 1061 Harmon Ave Fort Stewart, GA - 313145641 |
Business Phone Number: | 9123152205 |
Business Fax Number: | |
Mailing Address: | 1061 Harmon Ave, FORT STEWART |
State: | GA |
Postal Code: | 313145641 |
Phone Number: | 9123158916 |
Fax Number: | |
NPI Enumeration Date: | 04/14/2011 |
NPI Last Update Date: | 10/22/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 6192 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |