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General NPI Number Information
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NPI Number | 1598291304
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Entity Type | Organization
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Legal Business Name | PINKHEALTH, LLC
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Dates
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Enumeration Date | 05/11/2017
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Last Update Date | 05/11/2017
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Provider Practice Location Address
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Address Line | 12725 W INDIAN SCHOOL RD SUITE E 101
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City | AVONDALE
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State | AZ
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Zip | 85392-9520
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Country | US
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Telephone | 480-442-3834
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Fax | 623-243-5751
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Provider Business Mailing Address
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Address Line | 12725 W INDIAN SCHOOL RD SUITE E 101
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City | AVONDALE
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State | AZ
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Zip | 85392-9520
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Country | US
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Telephone | 480-442-3834
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Fax | 623-243-5751
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | DR. ERICA K KING
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Credential |
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Telephone | 480-442-3834
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 3312
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 103TH0004X
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Taxonomy Name | Health Psychologist
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License Number |
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License Number State |
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