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General NPI Number Information
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NPI Number | 1487143152
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Entity Type | Organization
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Legal Business Name | DESERT RAIN HEALTH AND WELLBEING
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Dates
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Enumeration Date | 05/08/2018
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 12725 W INDIAN SCHOOL RD STE 102
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City | AVONDALE
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State | AZ
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Zip | 85392
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Country | US
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Telephone | 602-399-0397
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Fax |
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Provider Business Mailing Address
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Address Line | 18809 W ELM ST
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City | LITCHFIELD PARK
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State | AZ
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Zip | 85340-9560
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Country | US
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Telephone | 623-687-7460
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Fax | 480-247-4038
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. NEIL SEABERN STAFFORD
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Credential | PSY.D.
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Telephone | 623-687-7460
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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 | 3691
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License Number State | AZ
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