Provider Demographics
NPI:1285620930
Name:HUISH, PAT COLLINSWORTH (PHD)
Entity type:Individual
Prefix:DR
First Name:PAT
Middle Name:COLLINSWORTH
Last Name:HUISH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14045 N 7TH ST
Mailing Address - Street 2:SUITE #4
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-4388
Mailing Address - Country:US
Mailing Address - Phone:602-993-4595
Mailing Address - Fax:602-993-7440
Practice Address - Street 1:14045 N 7TH ST
Practice Address - Street 2:SUITE #4
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85022-4388
Practice Address - Country:US
Practice Address - Phone:602-993-4595
Practice Address - Fax:602-993-7440
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1993103T00000X
CAMFC 19964106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ302853OtherAETNA/MAGELLAN INSURANCE
AZAZ0604530OtherBLUE CROSS BLUE SHIELD
AZAZ0604530OtherBLUE CROSS BLUE SHIELD
AZPHD1993Medicare ID - Type Unspecified