Healthcare Provider Details

I. General information

NPI: 1972181113
Provider Name (Legal Business Name): TRIUMPH PSYCHOLOGY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2021
Last Update Date: 03/30/2021
Certification Date: 03/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W RAY RD
CHANDLER AZ
85225-7260
US

IV. Provider business mailing address

1889 W QUEEN CREEK RD APT 1037
CHANDLER AZ
85248-3084
US

V. Phone/Fax

Practice location:
  • Phone: 520-227-0928
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State

VIII. Authorized Official

Name: LUIS R. SANCHEZ
Title or Position: OWNER
Credential: PHD
Phone: 520-227-0928