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General NPI Number Information
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NPI Number | 1174212302
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Entity Type | Organization
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Legal Business Name | DESERT RAIN PSYCHOLOGICAL SERVICES LLC
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Dates
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Enumeration Date | 05/03/2023
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Last Update Date | 11/09/2023
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Provider Practice Location Address
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Address Line | 4250 E KILMER ST
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City | TUCSON
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State | AZ
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Zip | 85711-2826
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Country | US
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Telephone | 520-349-2219
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Fax |
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Provider Business Mailing Address
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Address Line | 3849 E BROADWAY BLVD # 127
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City | TUCSON
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State | AZ
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Zip | 85716-5407
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Country | US
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Telephone | 520-349-2219
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KATHLEEN YOUNG
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Credential | PSY.D.
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Telephone | 520-261-0265
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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 |
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License Number State |
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