Dr EVERETT D DEHAVEN SR. CP is a male medical professional, specializing in Psychologist, Clinical. He graduated in 1976.
FREDERICK J TIRRELL PHD PROFESSIONAL ASSOCIATION
3515 S 4TH ST
101 PROFESSIONAL ASSOCIATION
LEAVENWORTH
KS
660485079
Tel: 9136518415
| Npi | 1083653851 |
| Pac Id | 2769420900 |
| Professional Enrollment Id | I20050419001058 |
| Last Name | DEHAVEN |
| First Name | EVERETT |
| Middle Name | D |
| Suffix | SR. |
| Gender | M |
| Credential | CP |
| Medical School Name | OTHER |
| Graduation Year | 1976 |
| Primary Specialty | PSYCHOLOGIST, CLINICAL |
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| Organization Legal Name | FREDERICK J TIRRELL PHD PROFESSIONAL ASSOCIATION |
| Group Practice Pac Id | 8224017157 |
| Number Of Group Practice Members | 5 |
| Line 1 Street Address | 3515 S 4TH ST |
| Line 2 Street Address | 101 PROFESSIONAL ASSOCIATION |
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| City | LEAVENWORTH |
| State | KS |
| Zip Code | 660485079 |
| Phone Number | 9136518415 |
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| Professional Accepts Medicare Assignment | Y |
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