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General NPI Number Information
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NPI Number | 1851375752
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Entity Type | Individual
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Provider Name | KATHLEEN A. TODD LCSW
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Gender | Female
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Dates
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Enumeration Date | 12/04/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 8727 S. PRIEST DR. SUITE 101
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City | TEMPE
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State | AZ
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Zip | 85284
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Country | US
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Telephone | 480-831-7342
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Fax |
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Provider Business Mailing Address
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Address Line | 2643 N EL DORADO PL
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City | CHANDLER
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State | AZ
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Zip | 85224-1787
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Country | US
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Telephone | 480-831-7342
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Fax |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW065I
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License Number State | AZ
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