NPI 1750594115

Philip E Sundstrom, MALICPSYCHOLOGIS

Practitioner Psychologist Fayetteville, WV

Practice location

Address: 209 W Maple Ave, Fayetteville, WV 25840-1413
Phone: (304) 574-2100
Fax: (304) 574-2151

Registered specialties

Psychologist Primary

Behavioral Health & Social Service Providers Taxonomy 103T00000X Licence 257 (WV)

Other Psychologist providers in West Virginia →

Registry record

NPI: 1750594115
Entity type: Individual
Sex (as registered): Male
NPI issued: 8 May 2007
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.