Individual
DR. LYNDA KRISTEN VATERLAUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
3602 E GREENWAY RD STE 102, PHOENIX, AZ 85032-4648
(602) 560-2832
(317) 520-8200
Mailing address
3500 DEPAUW BLVD STE 3070, INDIANAPOLIS, IN 46268-6135
(855) 324-0885
(317) 520-8200
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY-004161
AZ
103TC0700X
Clinical Psychologist
PSY-004161
AZ
103TH0100X
Health Service Psychologist
PSY-004161
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
620393
—
AZ
Enumeration date
08/22/2008
Last updated
05/07/2020
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