| Doctor Name: | EVERETT DEANE DEHAVEN |
| NPI Number: | 1083653851 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | LP 0554 |
| Business Practice Address: | 809 Elmhurst Blvd Salina, KS - 674017405 |
| Business Phone Number: | 7858236322 |
| Business Fax Number: | 7858233109 |
| Mailing Address: | 809 Elmhurst Blvd, SALINA |
| State: | KS |
| Postal Code: | 674017405 |
| Phone Number: | 7858236322 |
| Fax Number: | 7858233109 |
| NPI Enumeration Date: | 06/06/2006 |
| NPI Last Update Date: | 04/01/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | LP 0554 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KS |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |