Doctor Name: | DR. LYNDA K VATERLAUS |
NPI Number: | 1154578938 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSYD |
License Number: | 8690 |
Business Practice Address: | 140 North Litchfield Road Goodyear, AZ - 853381226 |
Business Phone Number: | 6022437277 |
Business Fax Number: | 6023238048 |
Mailing Address: | 2702 North 3rd Street, 4020 PHOENIX |
State: | AZ |
Postal Code: | 850044608 |
Phone Number: | 6023233344 |
Fax Number: | 6023233496 |
NPI Enumeration Date: | 08/22/2008 |
NPI Last Update Date: | 11/08/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 8690 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NE |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |