Healthcare Provider Details

I. General information

NPI: 1023770864
Provider Name (Legal Business Name): ANNYSA SAPIEN EDS, NCSP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2021
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1556 W PRINCE RD
TUCSON AZ
85705-3024
US

IV. Provider business mailing address

5001 N SHANNON RD
TUCSON AZ
85705-1048
US

V. Phone/Fax

Practice location:
  • Phone: 520-696-8812
  • Fax:
Mailing address:
  • Phone:
  • Fax: 520-696-8835

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: