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General NPI Number Information
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NPI Number | 1992327670
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Entity Type | Individual
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Provider Name | SARAH BALD PSYD
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Gender | Female
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Dates
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Enumeration Date | 05/15/2020
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Last Update Date | 09/22/2020
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Provider Practice Location Address
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Address Line | 15650 N BLACK CANYON HWY
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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 |
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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 | 26-284-4555
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 5036
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License Number State | AZ
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