=====================================================
General NPI Number Information
=====================================================
NPI Number | 1144897265
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LUKE THARIN BIGLER PSY.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/08/2021
-----------------------------------------------------
Last Update Date | 01/25/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3651 E. BASELINE ROAD SUITE E.222
-----------------------------------------------------
City | GILBERT
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85234-2689
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-432-3567
-----------------------------------------------------
Fax | 480-542-2648
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3651 E. BASELINE ROAD SUITE E.222
-----------------------------------------------------
City | GILBERT
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85234-2689
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-432-3567
-----------------------------------------------------
Fax | 480-542-2648
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TC0700X
-----------------------------------------------------
Taxonomy Name | Clinical Psychologist
-----------------------------------------------------
License Number | PSY.005436
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 103TC0700X
-----------------------------------------------------
Taxonomy Name | Clinical Psychologist
-----------------------------------------------------
License Number | PSY-005436
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------