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General NPI Number Information
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NPI Number | 1952760894
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Entity Type | Individual
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Provider Name | CASEY IWAI PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 02/21/2016
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Last Update Date | 02/21/2016
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Provider Practice Location Address
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Address Line | 1705 E HANNA RD
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City | ELOY
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State | AZ
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Zip | 85131-9612
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Country | US
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Telephone | 602-882-1810
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Fax |
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Provider Business Mailing Address
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Address Line | 3412 W ANSELL RD
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City | LAVEEN
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State | AZ
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Zip | 85339-1764
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Country | US
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Telephone | 602-237-2157
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 4691
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License Number State | AZ
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