Healthcare Provider Details

I. General information

NPI: 1396883039
Provider Name (Legal Business Name): DAWN RENEE TRUEBLOOD PH.D,, NCSP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DAWN HUBER PHD, NCSP

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 10/20/2025
Certification Date: 10/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3502 E GREENWAY LN STE 102
PHOENIX AZ
85032-4526
US

IV. Provider business mailing address

3500 DEPAUW BLVD STE 3070
INDIANAPOLIS IN
46268-6135
US

V. Phone/Fax

Practice location:
  • Phone: 602-560-2832
  • Fax: 317-520-8200
Mailing address:
  • Phone: 855-324-0885
  • Fax: 317-520-8200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY-004081
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number4081
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: