Healthcare Provider Details

I. General information

NPI: 1396256251
Provider Name (Legal Business Name): DEV ASHISH PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2017
Last Update Date: 11/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3045 N 1ST AVE STE A
TUCSON AZ
85719-2560
US

IV. Provider business mailing address

3045 N 1ST AVE STE A
TUCSON AZ
85719-2560
US

V. Phone/Fax

Practice location:
  • Phone: 719-200-8224
  • Fax: 844-227-8699
Mailing address:
  • Phone: 520-539-6455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number4907
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number4907
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number4907
License Number StateAZ
# 4
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number4907
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: