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General NPI Number Information
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NPI Number | 1215746052
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Entity Type | Organization
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Legal Business Name | HOLISTIC BEHAVIORAL & PSYCHOLOGICAL SERVICES, CORP.
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Dates
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Enumeration Date | 01/06/2025
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Last Update Date | 01/06/2025
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Provider Practice Location Address
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Address Line | 10565 N 114TH ST STE 107
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City | SCOTTSDALE
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State | AZ
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Zip | 85259-4942
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Country | US
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Telephone | 480-256-9596
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Fax | 480-716-4020
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Provider Business Mailing Address
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Address Line | 10565 N 114TH ST STE 107
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City | SCOTTSDALE
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State | AZ
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Zip | 85259-4942
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Country | US
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Telephone | 480-256-9596
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Fax | 480-716-4020
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Authorized Official
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Title or Position | CEO
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Name | DR. ELENA MARIE RIVERA
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Credential | PSYD.
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Telephone | 602-292-4680
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number |
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License Number State |
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Taxonomy #2
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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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