Healthcare Provider Details

I. General information

NPI: 1992729479
Provider Name (Legal Business Name): BARRY W LINDEN PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5310 W THUNDERBIRD RD STE 309
GLENDALE AZ
85306-4710
US

IV. Provider business mailing address

5310 W THUNDERBIRD RD STE 309
GLENDALE AZ
85306-4710
US

V. Phone/Fax

Practice location:
  • Phone: 602-938-3323
  • Fax: 602-938-1626
Mailing address:
  • Phone: 602-938-3323
  • Fax: 602-938-1626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number1715
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: