Provider Demographics
NPI:1790659068
Name:MUSORE, THIERRY
Entity type:Individual
Prefix:
First Name:THIERRY
Middle Name:
Last Name:MUSORE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3425 W DEER VALLEY RD UNIT 161
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-2262
Mailing Address - Country:US
Mailing Address - Phone:602-427-7152
Mailing Address - Fax:
Practice Address - Street 1:3425 W DEER VALLEY RD UNIT 161
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-2262
Practice Address - Country:US
Practice Address - Phone:602-427-7152
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-30
Last Update Date:2025-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician