| NPI | 1881087369 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANE A HIGGINS Owner 623-977-6860 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: AZ 3656) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: AZ 3656) |
| Enumeration Date | 2015-03-09 |
| Last Update Date | 2020-10-19 |