Individual
DR. MICHAEL STEFANOV
Active
Individual
DR. MICHAEL STEFANOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
PS016606
PA
103TB0200X
Cognitive & Behavioral Psychologist
PS016606
PA
103TC0700X
Clinical Psychologist
Primary
PS016606
PA
103TC2200X
Clinical Child & Adolescent Psychologist
PS016606
PA
103TF0000X
Family Psychologist
PS016606
PA
103TF0200X
Forensic Psychologist
PS016606
PA
103TH0004X
Health Psychologist
PS016606
PA
103TM1800X
Intellectual & Developmental Disabilities Psychologist
PS016606
PA
103TP2701X
Group Psychotherapy Psychologist
PS016606
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PS016606
—
PA
Enumeration date
07/02/2007
Last updated
02/27/2019
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