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General NPI Number Information
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NPI Number | 1780629923
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Entity Type | Organization
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Legal Business Name | HEARTS AND MINDS, INC.
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Dates
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Enumeration Date | 06/20/2006
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Last Update Date | 02/13/2013
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Provider Practice Location Address
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Address Line | 7220 N 16TH ST SUITE G
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City | PHOENIX
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State | AZ
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Zip | 85020-5253
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Country | US
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Telephone | 602-944-0480
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Fax | 602-944-0482
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Provider Business Mailing Address
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Address Line | 7220 N 16TH ST SUITE G
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City | PHOENIX
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State | AZ
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Zip | 85020-5253
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Country | US
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Telephone | 602-944-0480
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Fax | 602-944-0482
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARC S. WALTER
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Credential | PHD
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Telephone | 602-944-0480
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | PHD856
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License Number State | AZ
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