Tracey Renee Sridharan ED.S., NCSP

NPI 1073654067 - Psychologist - 103TS0200X

NPI Details
NPI 1073654067
Gender Female
Enumeration Date 02/11/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
2043 N 64TH DR
PHOENIX AZ, 85035-3424, US
Phone (623) 691-5518
Fax
Business Location
2513 W PARK ST
PHOENIX AZ, 85041-6488, US
Phone
Fax
Toxanomy
Taxonomy Code 103TS0200X
License State Arizona
License Number 3415771
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According to our database, Mrs. Tracey Renee Sridharan ED.S., NCSP NPI is 1073654067, taxonomy code is 103TS0200X and license number is 3415771, license state is located at Arizona. Tracey Renee Sridharan ED.S., NCSP physically located at 2043 N 64th Dr, Phoenix AZ, 85035-3424. NPI Number Tracey Renee Sridharan ED.S., NCSP has the Individual type.

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1073654067 NPI number is provided on an as is basis without warranty of any kind. 1073654067 is maintained by the National Plan & Provider Enumeration System. The contents of Tracey Renee Sridharan ED.S., NCSP are for informational purposes only.