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General NPI Number Information
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NPI Number | 1477095024
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Entity Type | Organization
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Legal Business Name | BRAIN-BODY WELLNESS AND BIOFEEDBACK
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Dates
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Enumeration Date | 11/14/2016
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Last Update Date | 11/14/2016
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Provider Practice Location Address
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Address Line | 10752 N 89TH PL STE 227C
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-6745
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Country | US
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Telephone | 480-744-3040
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Fax |
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Provider Business Mailing Address
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Address Line | 10752 N 89TH PL STE 227C
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-6745
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ALEXANDRA SCHILLING
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Credential | PSY.D.
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Telephone | 480-744-3040
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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 | 4772
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License Number State | AZ
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