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General NPI Number Information
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NPI Number | 1841385994
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Entity Type | Organization
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Legal Business Name | CARLSON & PALMER PC
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1545 W NORTHERN AVE
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City | PHOENIX
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State | AZ
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Zip | 85021-5453
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Country | US
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Telephone | 602-331-8200
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Fax | 602-331-0755
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Provider Business Mailing Address
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Address Line | 1545 W NORTHERN AVE
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City | PHOENIX
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State | AZ
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Zip | 85021-5453
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Country | US
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Telephone | 602-331-8200
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Fax | 602-331-0755
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHAEL BARRY PALMER
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Credential | PHD
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Telephone | 602-331-8200
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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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