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General NPI Number Information
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NPI Number | 1477924256
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE FITNESS & CONSULTATION, LLC
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Dates
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Enumeration Date | 10/19/2015
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Last Update Date | 10/19/2015
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Provider Practice Location Address
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Address Line | 34406 N 27TH DR BLDG 6, SUITE 118
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City | PHOENIX
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State | AZ
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Zip | 85085-6082
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Country | US
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Telephone | 623-215-9958
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Fax | 623-215-9959
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Provider Business Mailing Address
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Address Line | 34406 N 27TH DR BLDG 6, SUITE 118
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City | PHOENIX
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State | AZ
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Zip | 85085-6082
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Country | US
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Telephone | 623-215-9958
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Fax | 623-215-9959
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. AMY K WHITE
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Credential | PSYD
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Telephone | 623-215-9958
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 4670
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License Number State | AZ
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