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Individual

DR. LAWRENCE JAMES STAVA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
705 W MAIN ST, SUITE 3, SUN PRAIRIE, WI 53590-2849
(608) 825-6663
(608) 825-6946
Mailing address
705 W MAIN ST, SUITE 3, SUN PRAIRIE, WI 53590-2849
(608) 825-6663
(608) 825-6946

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
966-057
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1011066
PHYSICIAN PLUS INSURANCE
WI
05
39030200
WI
01
39172774704
UNITY HEALTH PLAN
WI
Enumeration date
09/27/2006
Last updated
07/08/2007
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