Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | PSY202371 |
NPI | 1023287612 |
---|---|
Provider Name | Dr. Steven Randall Lawyer |
First Address | Pocatello, ID 83209-8112 |
Second Address | Pocatello, ID 83209-8112 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2008 |
Last Update Date | 27/02/2008 |