| NPI | 1184145047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH J. GOLDBERG 100 Owner/President 480-831-0746 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: AZ 1045) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: AZ 1045) |
| 103TC1900X Psychologist Counseling (Licence: AZ 1045) | |
| 103TF0000X Psychologist Family (Licence: AZ 1045) | |
| Enumeration Date | 2017-06-30 |
| Last Update Date | 2017-06-30 |