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General NPI Number Information
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NPI Number | 1932559598
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Entity Type | Organization
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Legal Business Name | CARRIE TREMBLE, PH.D., PLLC
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Dates
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Enumeration Date | 06/15/2016
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Last Update Date | 06/15/2016
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Provider Practice Location Address
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Address Line | 3651 E BASELINE RD
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City | GILBERT
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State | AZ
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Zip | 85234-2689
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Country | US
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Telephone | 480-269-5547
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Fax |
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Provider Business Mailing Address
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Address Line | 4848 N GOLDWATER BLVD UNIT 4054
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-1054
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Country | US
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Telephone | 269-598-2748
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. CARRIE J TREMBLE
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Credential | PH.D., LPC
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Telephone | 269-598-2748
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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 | LPC-16041
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License Number State | AZ
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