Healthcare Provider Details

I. General information

NPI: 1851542112
Provider Name (Legal Business Name): KELLI ROBYN SAX-PAHL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2008
Last Update Date: 05/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10799 N 90TH ST STE. 100
SCOTTSDALE AZ
85260-6110
US

IV. Provider business mailing address

1400 E. SOUTHERN AVE STE. 735
TEMPE AZ
85282-2692
US

V. Phone/Fax

Practice location:
  • Phone: 480-804-0326
  • Fax: 480-804-0083
Mailing address:
  • Phone: 480-804-0326
  • Fax: 480-804-0083

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-2621
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: