Healthcare Provider Details

I. General information

NPI: 1932217841
Provider Name (Legal Business Name): TOBIE DIMONT M. ED. LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

380 E FT LOWELL RD #203
TUCSON AZ
85705
US

IV. Provider business mailing address

4945 N VIA CONDESA
TUCSON AZ
85718
US

V. Phone/Fax

Practice location:
  • Phone: 520-299-0888
  • Fax:
Mailing address:
  • Phone: 520-299-0888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberLPC0418
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: