Healthcare Provider Details

I. General information

NPI: 1194855981
Provider Name (Legal Business Name): KARLAYE DIMANCHE-RAFINDADI PH.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 04/04/2025
Certification Date: 04/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2240 WINROW RD
FORT HUACHUCA AZ
85613-5080
US

IV. Provider business mailing address

2240 WINROW RD
FORT HUACHUCA AZ
85613-5080
US

V. Phone/Fax

Practice location:
  • Phone: 520-533-5161
  • Fax:
Mailing address:
  • Phone: 520-533-5161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number000411
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number4045
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number4045
License Number StateAZ
# 4
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number StateAZ
# 5
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number4045
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: