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General NPI Number Information
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NPI Number | 1831188176
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Entity Type | Individual
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Provider Name | MICHAEL EDWARD TANSY PHD
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Gender | Male
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Dates
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Enumeration Date | 10/19/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3681 E BASELINE RD SUITE 222
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City | GILBERT
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State | AZ
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Zip | 85234-2647
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Country | US
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Telephone | 480-966-9337
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Fax | 480-704-5181
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Provider Business Mailing Address
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Address Line | 3681 E BASELINE RD SUITE 222
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City | GILBERT
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State | AZ
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Zip | 85234-2647
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Country | US
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Telephone | 480-966-9337
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Fax | 480-704-5181
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 3285
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License Number State | AZ
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