MEDICARE: DR. BRIANNA ALDRICH PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PSY-005256	AZ

General Provider Information

NPI Number	:	1447785936
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIANNA ALDRICH PSY.D.

Provider Business Mailing Address
First Line	:	7600 N 15TH ST STE 150
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85020-4305
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7600 N 15TH ST STE 150
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85020-4305
Country	:	US
Telephone Number	:	602-334-1353
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/22/2017
Last Update Date	:	06/02/2020

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