Provider Demographics
NPI:1396127197
Name:PALUC, BRENDA JEAN (PHD)
Entity type:Individual
Prefix:DR
First Name:BRENDA
Middle Name:JEAN
Last Name:PALUC
Suffix:
Gender:F
Credentials:PHD
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Mailing Address - Street 1:3400 N DYSART RD
Mailing Address - Street 2:#117
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85392-1003
Mailing Address - Country:US
Mailing Address - Phone:623-535-7956
Mailing Address - Fax:623-536-9806
Practice Address - Street 1:3400 N DYSART RD
Practice Address - Street 2:#117
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85392-1003
Practice Address - Country:US
Practice Address - Phone:623-535-7956
Practice Address - Fax:623-536-9806
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-29
Last Update Date:2015-06-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ3618103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical