Basic Information
| Provider Information | |||||||||
| NPI: | 1154425767 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TUELLER | ||||||||
| FirstName: | STEPHEN | ||||||||
| MiddleName: | BRAUN | ||||||||
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| Credential: | PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1920 N 2050 E | ||||||||
| Address2: | |||||||||
| City: | LAYTON | ||||||||
| State: | UT | ||||||||
| PostalCode: | 840402300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8015936179 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7309 11TH ST BLDG 545 | ||||||||
| Address2: | |||||||||
| City: | HILL AIR FORCE BASE | ||||||||
| State: | UT | ||||||||
| PostalCode: | 840565012 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8017777909 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/12/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | 334 | SD | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.