| NPI | 1750150942 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN SHAW Director Of Finance 602-218-8211 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| Enumeration Date | 2023-12-28 |
| Last Update Date | 2023-12-28 |