Provider Demographics
NPI:1699146910
Name:INTEGRATIVE PSYCHOTHERAPY AND ASSESSMENT SERVICES
Entity type:Organization
Organization Name:INTEGRATIVE PSYCHOTHERAPY AND ASSESSMENT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BYRD
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:602-526-8315
Mailing Address - Street 1:11024 N 28TH DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85029-4377
Mailing Address - Country:US
Mailing Address - Phone:602-526-8315
Mailing Address - Fax:
Practice Address - Street 1:11024 N 28TH DR
Practice Address - Street 2:SUITE 200
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029-4377
Practice Address - Country:US
Practice Address - Phone:602-526-8315
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-13
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty