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General NPI Number Information
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NPI Number | 1851689376
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Entity Type | Individual
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Provider Name | RAMASWAMY KAVITHA PERUMPARAICHALLAI PH.D.
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Gender | Female
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Dates
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Enumeration Date | 07/18/2011
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Last Update Date | 08/18/2021
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Provider Practice Location Address
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Address Line | 2400 N CENTRAL AVE STE 204
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City | PHOENIX
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State | AZ
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Zip | 85004-1341
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Country | US
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Telephone | 623-295-9119
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Fax | 888-819-1123
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Provider Business Mailing Address
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Address Line | 530 E MCDOWELL RD STE 107-427
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City | PHOENIX
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State | AZ
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Zip | 85004-1549
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Country | US
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Telephone | 602-935-7152
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Fax | 888-819-1123
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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 | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 4203
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License Number State | AZ
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