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General NPI Number Information
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NPI Number | 1528182763
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Entity Type | Individual
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Provider Name | MARIA ELIDA MESSICK PH.D
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Gender | Female
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Dates
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Enumeration Date | 03/16/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 7125 W ENCANTO BLVD
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City | PHOENIX
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State | AZ
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Zip | 85035-1335
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Country | US
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Telephone | 623-691-5618
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Fax | 623-691-5620
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Provider Business Mailing Address
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Address Line | 6611 W LARIAT LN
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City | GLENDALE
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State | AZ
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Zip | 85310-1046
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Country | US
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Telephone | 623-691-5618
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Fax | 623-691-5620
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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 | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 3090235
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License Number State | AZ
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