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General NPI Number Information
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NPI Number | 1710167663
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Entity Type | Organization
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Legal Business Name | BILL RETTS PHD PC
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Dates
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Enumeration Date | 11/08/2007
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Last Update Date | 11/08/2007
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Provider Practice Location Address
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Address Line | 11024 N 28TH DR STE 290
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City | PHOENIX
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State | AZ
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Zip | 85029-4373
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Country | US
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Telephone | 602-870-7710
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Fax | 602-734-0692
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Provider Business Mailing Address
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Address Line | 801 W BUTLER DR
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City | PHOENIX
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State | AZ
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Zip | 85021-4454
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Country | US
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Telephone | 602-997-1075
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Fax | 602-354-7503
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Authorized Official
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Title or Position | PRESIDENT
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Name | WILLIAM L RETTS
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Credential | PHD
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Telephone | 602-997-1075
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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 |
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License Number State |
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