Healthcare Provider Details

I. General information

NPI: 1023496825
Provider Name (Legal Business Name): T. M. BARRATT, PHD, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2015
Last Update Date: 05/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7227 N 16TH ST STE 219
PHOENIX AZ
85020-5257
US

IV. Provider business mailing address

PO BOX 1861
PHOENIX AZ
85001-1861
US

V. Phone/Fax

Practice location:
  • Phone: 602-216-6900
  • Fax: 602-371-9889
Mailing address:
  • Phone: 480-779-9855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number4564
License Number StateAZ

VIII. Authorized Official

Name: DR. T. M. BARRATT
Title or Position: PSYCHOLOGIST
Credential: PHD
Phone: 480-779-9855