Individual
DR. PETER L STAVINOHA
Active
Individual
DR. PETER L STAVINOHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
25476
TX
103TC0700X
Clinical Psychologist
25476
TX
103TC2200X
Clinical Child & Adolescent Psychologist
25476
TX
103TM1800X
Intellectual & Developmental Disabilities Psychologist
25476
TX
103TR0400X
Rehabilitation Psychologist
25476
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
039133606
—
TX
01
—
039133607
CSHCN TPI
TX
Enumeration date
12/04/2006
Last updated
08/18/2020
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