Individual
DR. THEODORE WEBSTER ETLING JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
7400 S POWER RD STE 120, GILBERT, AZ 85297-9283
(480) 926-0644
(480) 926-0645
Mailing address
7400 S POWER RD STE 120, GILBERT, AZ 85297-9283
(480) 926-0644
(480) 926-0645
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
4204
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
644018
—
AZ
Enumeration date
09/24/2010
Last updated
10/17/2023
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