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General NPI Number Information
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NPI Number | 1891497350
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Entity Type | Organization
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Legal Business Name | NEST PSYCHOLOGICAL, LLC
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Dates
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Enumeration Date | 03/20/2023
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Last Update Date | 03/20/2023
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Provider Practice Location Address
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Address Line | 15650 N BLACK CANYON HWY STE B140
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City | PHOENIX
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State | AZ
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Zip | 85053-4064
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Country | US
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Telephone | 602-284-4555
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Fax | 602-354-3206
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Provider Business Mailing Address
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Address Line | 15650 N BLACK CANYON HWY STE B140
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City | PHOENIX
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State | AZ
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Zip | 85053-4064
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Country | US
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Telephone | 602-284-4555
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Fax | 602-354-3206
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Authorized Official
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Title or Position | OWNER
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Name | SARAH BALD
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Credential | PSYD
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Telephone | 602-284-4555
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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 |
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License Number State |
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