Healthcare Provider Details

I. General information

NPI: 1407923949
Provider Name (Legal Business Name): BRENDA MARIE SPARROLD PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 08/05/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8478 EAST SPEEDWAY BLVD SUITE 305
TUCSON AZ
85710-1730
US

IV. Provider business mailing address

8478 EAST SPEEDWAY BLVD SUITE 305
TUCSON AZ
85710-1730
US

V. Phone/Fax

Practice location:
  • Phone: 520-390-1042
  • Fax: 888-978-8171
Mailing address:
  • Phone: 520-390-1042
  • Fax: 888-978-8171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number3798
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number3798
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: