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General NPI Number Information
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NPI Number | 1598150088
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Entity Type | Organization
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Legal Business Name | SARAH EDMONDS PHD PLLC
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Dates
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Enumeration Date | 04/01/2015
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Last Update Date | 04/01/2015
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Provider Practice Location Address
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Address Line | 300 E WILLIS ST SUITE E
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City | PRESCOTT
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State | AZ
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Zip | 86301-3110
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Country | US
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Telephone | 928-830-4661
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Fax |
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Provider Business Mailing Address
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Address Line | 300 E WILLIS ST SUITE E
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City | PRESCOTT
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State | AZ
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Zip | 86301-3110
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Country | US
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Telephone | 928-830-4661
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | SARAH EDMONDS
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Credential | PH.D.
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Telephone | 928-830-4661
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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 | 3481
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License Number State | AZ
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