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General NPI Number Information
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NPI Number | 1508823766
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Entity Type | Individual
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Provider Name | AZITA ABTIN PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 04/28/2006
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Last Update Date | 03/24/2014
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Provider Practice Location Address
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Address Line | 5210 E PIMA ST SUITE 200
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City | TUCSON
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State | AZ
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Zip | 85712-3664
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Country | US
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Telephone | 520-272-9497
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Fax | 520-795-3575
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Provider Business Mailing Address
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Address Line | 1475 S ABBIE LN
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City | TUCSON
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State | AZ
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Zip | 85710-8543
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Country | US
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Telephone | 520-272-9497
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Fax | 520-795-3575
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 3620
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License Number State | AZ
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