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Individual

MR. STEPHEN EDWARD FATZINGER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPA

Contact information

Practice address
299 OLD FELLOWSHIP RD, SWANNANOA, NC 28778-2709
(828) 299-0299
(828) 299-0299
Mailing address
299 OLD FELLOWSHIP RD, SWANNANOA, NC 28778-2709
(828) 299-0299
(828) 299-0299

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1588
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1588
LPA LICENSE NUMBER
NC
05
6107233
NC
Enumeration date
03/11/2007
Last updated
07/09/2007
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