Provider Demographics
NPI:1982409868
Name:DESERT ROSE NEUROPSYCHOLOGY PLLC
Entity type:Organization
Organization Name:DESERT ROSE NEUROPSYCHOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:MAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:305-986-1148
Mailing Address - Street 1:4865 E MURIEL DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-0009
Mailing Address - Country:US
Mailing Address - Phone:305-986-1148
Mailing Address - Fax:
Practice Address - Street 1:13430 N SCOTTSDALE RD STE 204
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-4058
Practice Address - Country:US
Practice Address - Phone:305-986-1148
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-15
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty