Healthcare Provider Details

I. General information

NPI: 1558549204
Provider Name (Legal Business Name): JANICE MOTOIKE, PH.D., P.L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2008
Last Update Date: 01/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

428 S GILBERT RD STE 109-M
GILBERT AZ
85296-2263
US

IV. Provider business mailing address

1955 W BASELINE RD STE 113-520
MESA AZ
85202-9003
US

V. Phone/Fax

Practice location:
  • Phone: 480-313-3080
  • Fax: 602-396-5696
Mailing address:
  • Phone: 480-313-3080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number3701
License Number StateAZ

VIII. Authorized Official

Name: DR. JANICE MOTOIKE
Title or Position: MEMBER
Credential: PHD
Phone: 480-313-3080