Healthcare Provider Details

I. General information

NPI: 1609986660
Provider Name (Legal Business Name): HEATHER S CAPLES PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 10/16/2024
Certification Date: 10/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 W THOMAS RD STE 401
PHOENIX AZ
85013-4423
US

IV. Provider business mailing address

240 W THOMAS RD # 301
PHOENIX AZ
85013-4407
US

V. Phone/Fax

Practice location:
  • Phone: 602-406-3473
  • Fax: 602-406-4406
Mailing address:
  • Phone: 602-406-7765
  • Fax: 602-294-5519

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number3563
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: