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Organization

ARIZONA CHILDRENS THERAPY CENTER LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ROY EVANS (PARTNER)
(480) 510-1599
Entity
Organization

Contact information

Practice address
7545 W REDBIRD RD, PEORIA, AZ 85383-6253
(480) 510-1599
(623) 258-4136
Mailing address
8607 N 59TH AVE, SUITE C-6, GLENDALE, AZ 85302-5433

Taxonomy

Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
AZ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP5146
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
868036
AZ
Enumeration date
02/05/2014
Last updated
04/19/2023
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