| NPI | 1952546863 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM L JOHNSON Licensed Psychologist 480-491-5501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: AZ 1796) |
| Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging (Licence: AZ 1796) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: AZ 1796) | |
| Enumeration Date | 2008-12-05 |
| Last Update Date | 2008-12-05 |