Organization
THE CHILDRENS CENTER FOR NEURODEVELOPMENTAL STUDIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTINA MUSSER (BUSINESS SERVICES)
(623) 915-0345
Entity
Organization
Contact information
Practice address
5430 W GLENN DR, GLENDALE, AZ 85301-2628
(623) 915-0345
(623) 937-5425
Mailing address
5430 W GLENN DR, GLENDALE, AZ 85301-2628
(623) 915-0345
(623) 937-5425
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
4184
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4184
SPECIALIST
AZ
Enumeration date
07/30/2008
Last updated
07/30/2008
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