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General NPI Number Information
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NPI Number | 1699146910
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE PSYCHOTHERAPY AND ASSESSMENT SERVICES
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Dates
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Enumeration Date | 10/13/2015
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Last Update Date | 02/16/2016
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Provider Practice Location Address
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Address Line | 11024 N 28TH DR SUITE 200
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City | PHOENIX
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State | AZ
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Zip | 85029-4377
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Country | US
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Telephone | 602-526-8315
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Fax |
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Provider Business Mailing Address
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Address Line | 11024 N 28TH DR SUITE 200
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City | PHOENIX
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State | AZ
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Zip | 85029-4377
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Country | US
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Telephone | 602-526-8315
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. DAWN MARIE BYRD
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Credential | PSY.D.
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Telephone | 602-526-8315
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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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