Healthcare Provider Details

I. General information

NPI: 1336872027
Provider Name (Legal Business Name): SAIDO IGAL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2022
Last Update Date: 08/26/2024
Certification Date: 08/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2918 W PECAN RD
PHOENIX AZ
85041-4425
US

IV. Provider business mailing address

2918 W PECAN RD
PHOENIX AZ
85041-4425
US

V. Phone/Fax

Practice location:
  • Phone: 701-215-1769
  • Fax:
Mailing address:
  • Phone: 701-215-1769
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: