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General NPI Number Information
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NPI Number | 1316108665
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Entity Type | Individual
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Provider Name | THOMAS RUSSELL GEEN PH.D.
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Gender | Male
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Dates
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Enumeration Date | 06/19/2008
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Last Update Date | 03/25/2020
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Provider Practice Location Address
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Address Line | 4411 S RURAL RD STE 201
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City | TEMPE
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State | AZ
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Zip | 85282-7072
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Country | US
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Telephone | 612-930-2202
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Fax | 602-442-4085
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Provider Business Mailing Address
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Address Line | 3508 E VERBENA DR
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City | PHOENIX
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State | AZ
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Zip | 85044-6507
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Country | US
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Telephone | 480-516-9778
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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 | 103TF0200X
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Taxonomy Name | Forensic Psychologist
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License Number | 3572
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License Number State | AZ
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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 | 3572
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License Number State | AZ
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