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General NPI Number Information
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NPI Number | 1336328806
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Entity Type | Organization
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Legal Business Name | A POSITIVE OUTCOME NEUROPSYCHOLOGY SERVICES PLLC
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Dates
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Enumeration Date | 10/31/2007
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Last Update Date | 10/31/2007
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Provider Practice Location Address
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Address Line | 7227 N 16TH ST SUITE 222
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City | PHOENIX
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State | AZ
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Zip | 85020-5251
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Country | US
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Telephone | 623-512-8021
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Fax | 623-825-6784
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Provider Business Mailing Address
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Address Line | 7227 N 16TH ST SUITE 222
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City | PHOENIX
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State | AZ
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Zip | 85020-5251
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Country | US
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Telephone | 623-512-8021
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Fax | 623-825-6784
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Authorized Official
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Title or Position | CLINICAL NEUROPSYCHOLOGIST
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Name | DR. TRACY LYNN THOMAS
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Credential | PH.D.
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Telephone | 623-512-8021
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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 | 3573
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 3573
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License Number State | AZ
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