Healthcare Provider Details

I. General information

NPI: 1285620930
Provider Name (Legal Business Name): PAT COLLINSWORTH HUISH PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 09/27/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14045 N 7TH ST SUITE #4
PHOENIX AZ
85022-4388
US

IV. Provider business mailing address

14045 N 7TH ST SUITE #4
PHOENIX AZ
85022-4388
US

V. Phone/Fax

Practice location:
  • Phone: 602-993-4595
  • Fax: 602-993-7440
Mailing address:
  • Phone: 602-993-4595
  • Fax: 602-993-7440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number1993
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC 19964
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: