Provider Demographics
NPI:1427297043
Name:SYD PALMER, PH.D, PC.
Entity type:Organization
Organization Name:SYD PALMER, PH.D, PC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SYDNEY
Authorized Official - Middle Name:N
Authorized Official - Last Name:PALMER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:480-820-2058
Mailing Address - Street 1:1972 E BASELINE RD
Mailing Address - Street 2:B102
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-1532
Mailing Address - Country:US
Mailing Address - Phone:480-820-2058
Mailing Address - Fax:480-820-4001
Practice Address - Street 1:1972 E BASELINE RD
Practice Address - Street 2:B102
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-1532
Practice Address - Country:US
Practice Address - Phone:480-820-2058
Practice Address - Fax:480-820-4001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-05
Last Update Date:2009-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ881103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty