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Individual
CHAVEZ PHELPS
Active
Individual
CHAVEZ PHELPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
1257
LA
103T00000X
Psychologist
20043204A
IN
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
20043204A
IN
Other
Enumeration date
03/19/2014
Last updated
03/03/2020
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