Individual
MR. TIMOTHY HUGH VANDERVEEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A.
Contact information
Practice address
1113 W US HIGHWAY 60, SUPERIOR, AZ 85273-3429
(253) 208-1272
Mailing address
1113 W US HIGHWAY 60, SUPERIOR, AZ 85273-3429
(253) 208-1272
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
4003175
AZ
Other
Enumeration date
04/08/2008
Last updated
04/08/2008
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