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Individual

DR. MICHAEL J CAPONI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PSY.D, MA

Contact information

Practice address
527 TUSKEGEE AIRMAN BLVD, BUILDING 500, SHEPPARD AFB, TX 76311
(940) 676-6075
Mailing address
527 TUSKEGEE AIRMAN BLVD, BUILDING 500, SHEPPARD AFB, TX 76311
(940) 676-6075

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
178-004267
IL
103TC0700X
Clinical Psychologist
071-008147
IL
103TC0700X
Clinical Psychologist
Primary
37576
TX
103TC0700X
Clinical Psychologist
PSY004578
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01623882
BC/BS
IL
Enumeration date
09/24/2008
Last updated
09/25/2023
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