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NPI Code Detail

MEDICARE: CR MACCHI PHD

MEDICARE:   CR  MACCHI  PHD
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
1106H00000XMarriage & Family TherapistLCMFT 359KS

General Provider Information

NPI Number : 1588702153
Entity Type Code : Individual
Provider Name (Legal Business Name) : CR MACCHI PHD
Provider Business Mailing Address
First Line : 500 N. 3RD STREET MAIL CODE 3320
Second Line : DOCTOR OF BEHAVIORAL HEALTH, ARIZONA STATE UNIVERSITY
City : PHOENIX
State : AZ
Zip : 85004-2135
Country : US
Telephone Number : 602-496-1355
Fax Number : 602-496-1597
Provider Business Practice Location Address
First Line : 500 N. 3RD STREET MAIL CODE 3320
Second Line : DOCTOR OF BEHAVIORAL HEALTH, ARIZONA STATE UNIVERSITY
City : PHOENIX
State : AZ
Zip : 85004-2135
Country : US
Telephone Number : 602-496-1355
Fax Number : 602-496-1597
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2007
Last Update Date : 10/19/2012

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Directions to “ CR MACCHI PHD” Practice Location

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