| Doctor Name: | DR. SAMUEL ROBERT CARON |
| NPI Number: | 1831159045 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | |
| Business Practice Address: | 2240 E Winrow Ave Fort Huachuca, AZ - 856137079 |
| Business Phone Number: | 5205335161 |
| Business Fax Number: | |
| Mailing Address: | 226 N Canyon Dr, SIERRA VISTA |
| State: | AZ |
| Postal Code: | 856351518 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 03/23/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC2200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical Child & Adolescent |
| Taxonomy Definition: | |