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Individual

STEPHEN B GEMMELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
12 E APPLEBY RD, STE 101, FAYETTEVILLE, AR 72703-3901
(479) 463-4444
(479) 463-4499
Mailing address
12 E APPLEBY RD, STE 101, FAYETTEVILLE, AR 72703-3901
(479) 463-4444
(479) 463-4499

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0010P
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
154295719
AR
01
5W107
BLUE
AR
Enumeration date
05/11/2006
Last updated
04/25/2011
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