DR. Edward Staba, PSY.D

NPI #1275164543 in Marion, Illinois

Provider Information

NPI Number: 1275164543
Entity Type: Individual
Name: DR. Edward Staba, PSY.D
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Psychologist
Credential: PSY.D
Enumeration Date: Jan 27, 2020
Last Updated: Jan 27, 2020

Practice Location

Address: 2401 W MAIN ST
City: Marion
State: Illinois
ZIP Code: 62959-1188
Phone: (618) 997-5311

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist	103T00000X	Primary

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