| NPI | 1336335488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAY D SUMMERS Owner 480-945-3475 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: AZ 3119) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: AZ 3119) |
| 103TA0400X Psychologist Addiction (Substance Use Disorder) (Licence: AZ 3119) | |
| 103TB0200X Psychologist Cognitive & Behavioral (Licence: AZ 3119) | |
| 103TC0700X Psychologist Clinical (Licence: AZ 3119) | |
| 103TC1900X Psychologist Counseling (Licence: AZ 3119) | |
| 103TF0200X Psychologist Forensic (Licence: AZ 3119) | |
| 103TH0100X Psychologist Health Service (Licence: AZ 3119) | |
| 103TR0400X Psychologist Rehabilitation (Licence: AZ 3119) | |
| Enumeration Date | 2007-09-22 |
| Last Update Date | 2007-09-22 |