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NPI Code Detail

MEDICARE: DR. NANETTE M LEIGH PHD

MEDICARE: DR. NANETTE M LEIGH 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
1103T00000XPsychologist3398AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1614661OTHERAZAHCCCS PROVIDER ID

General Provider Information

NPI Number : 1639283161
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NANETTE M LEIGH PHD
Provider Business Mailing Address
First Line : 15002 N 32ND ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85032-4441
Country : US
Telephone Number : 602-867-5223
Fax Number : 602-867-5252
Provider Business Practice Location Address
First Line : 15002 N 32ND ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85032-4441
Country : US
Telephone Number : 602-867-5223
Fax Number : 602-867-5252
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2006
Last Update Date : 07/08/2007

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