Individual
MR. STEPHEN L. MAILLOUX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH. D.
Contact information
Practice address
800 EAST DIMOND BLVD SUITE 3-625, 800 EAST DIMOND BLVD SUITE 3-625, ANCHORAGE, AK 99515-2025
(907) 306-6525
Mailing address
800 EAST DIMOND BLVD SUITE 3-625, 800 EAST DIMOND BLVD SUITE 3-625, ANCHORAGE, AK 99515-2025
(907) 306-6525
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PSYP539
AK
174400000X
Specialist
539
AK
261QM2500X
Medical Specialty Clinic/Center
PSYP539
AK
Other
Enumeration date
11/05/2007
Last updated
04/12/2024
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