Provider Demographics
NPI:1962220756
Name:NEUBERGER, BRYCE
Entity type:Individual
Prefix:
First Name:BRYCE
Middle Name:
Last Name:NEUBERGER
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 1:20753 W THOMAS RD
Mailing Address - Street 2:
Mailing Address - City:BUCKEYE
Mailing Address - State:AZ
Mailing Address - Zip Code:85396-1649
Mailing Address - Country:US
Mailing Address - Phone:725-577-3231
Mailing Address - Fax:
Practice Address - Street 1:20753 W THOMAS RD
Practice Address - Street 2:
Practice Address - City:BUCKEYE
Practice Address - State:AZ
Practice Address - Zip Code:85396-1649
Practice Address - Country:US
Practice Address - Phone:725-577-3231
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral