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General NPI Number Information
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NPI Number | 1841527546
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Entity Type | Organization
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Legal Business Name | RORY B. MADDEN, ED.D., PC
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Dates
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Enumeration Date | 11/17/2009
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Last Update Date | 11/17/2009
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Provider Practice Location Address
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Address Line | 7915 N PARADISE CANYON LN
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City | PRESCOTT VALLEY
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State | AZ
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Zip | 86315-9098
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Country | US
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Telephone | 928-699-4476
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Fax |
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Provider Business Mailing Address
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Address Line | 7915 N PARADISE CANYON LN
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City | PRESCOTT VALLEY
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State | AZ
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Zip | 86315-9098
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Country | US
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Telephone | 928-699-4476
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Fax |
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Authorized Official
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Title or Position | LICENSED PSYCHOLOGIST
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Name | DR. RORY B. MADDEN
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Credential | ED.D.
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Telephone | 928-699-4476
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 1495
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License Number State | AZ
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