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General NPI Number Information
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NPI Number | 1124146519
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Entity Type | Individual
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Provider Name | MARSHA ELAINE FERRICK PH.D, BCC
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Gender | Female
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 34406 N 27TH DR STE 140
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City | PHOENIX
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State | AZ
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Zip | 85085-6079
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Country | US
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Telephone | 216-780-5068
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 203
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City | BLACK CANYON CITY
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State | AZ
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Zip | 85324-0203
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Country | US
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Telephone | 216-780-5068
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 4858
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License Number State | AZ
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