Healthcare Provider Details

I. General information

NPI: 1023197779
Provider Name (Legal Business Name): ROBERT BRUCE ST PIERRE M.A. EDUC. COUNSELIN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 07/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2250 S COLLEGE AVE
TEMPE AZ
85282-2252
US

IV. Provider business mailing address

20008 N JONES DR
MARICOPA AZ
85239-2526
US

V. Phone/Fax

Practice location:
  • Phone: 480-921-9003
  • Fax:
Mailing address:
  • Phone: 480-577-2314
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: