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General NPI Number Information
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NPI Number | 1639724891
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Entity Type | Organization
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Legal Business Name | ARIZONA PSYCHOLOGICAL AND COMMUNITY SUPPORT
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Dates
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Enumeration Date | 08/05/2019
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Last Update Date | 08/05/2019
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Provider Practice Location Address
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Address Line | 21630 N 19TH AVE STE B17
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City | PHOENIX
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State | AZ
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Zip | 85027-2715
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Country | US
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Telephone | 602-626-2018
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Fax |
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Provider Business Mailing Address
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Address Line | 21630 N 19TH AVE STE B17
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City | PHOENIX
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State | AZ
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Zip | 85027-2715
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Country | US
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Telephone | 602-626-2018
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHRISTINE BREUER
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Credential |
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Telephone | 602-525-2018
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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