Provider Demographics
NPI:1306174883
Name:STRASBERG, PATRICIA D (EDD)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:D
Last Name:STRASBERG
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 N EL DORADO PL
Mailing Address - Street 2:BUILDING H, SUITE 800
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85715-4637
Mailing Address - Country:US
Mailing Address - Phone:520-296-8171
Mailing Address - Fax:520-829-6057
Practice Address - Street 1:1200 N EL DORADO PL
Practice Address - Street 2:BUILDING H, SUITE 800
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85715-4637
Practice Address - Country:US
Practice Address - Phone:520-296-8171
Practice Address - Fax:520-829-6057
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-23
Last Update Date:2013-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3670103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ101357Medicare PIN