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General NPI Number Information
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NPI Number | 1295908234
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Entity Type | Organization
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Legal Business Name | CENTER FOR HEALING PLAY, INC
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Dates
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Enumeration Date | 04/10/2008
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Last Update Date | 05/27/2010
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Provider Practice Location Address
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Address Line | 2435 E SOUTHERN AVE SUITE 3
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City | TEMPE
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State | AZ
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Zip | 85282-7628
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Country | US
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Telephone | 480-894-2281
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Fax | 480-894-2282
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Provider Business Mailing Address
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Address Line | 1305 E CARSON DR
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City | TEMPE
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State | AZ
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Zip | 85282-7215
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Country | US
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Telephone | 602-690-0430
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Fax |
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Authorized Official
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Title or Position | PLAY THERAPIST/COUNSELOR
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Name | MRS. NANCY J. TAYLOR
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Credential | MC, LPC
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Telephone | 480-894-2281
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | LPC-10994
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License Number State | AZ
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