Healthcare Provider Details

I. General information

NPI: 1124922190
Provider Name (Legal Business Name): BLUNK INSIGHT SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16618 S 41ST ST
PHOENIX AZ
85048-0523
US

IV. Provider business mailing address

16618 S 41ST ST
PHOENIX AZ
85048-0523
US

V. Phone/Fax

Practice location:
  • Phone: 602-488-0221
  • Fax:
Mailing address:
  • Phone: 602-488-0221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. KELLY MAUREEN BLUNK
Title or Position: SCHOOL PSYCHOLOGIST
Credential: M.S.
Phone: 602-488-0221