Individual
NICOLE BURT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
7600 N 16TH ST STE 110, PHOENIX, AZ 85020-4446
(602) 615-0381
Mailing address
7600 N 16TH ST STE 110, PHOENIX, AZ 85020-4446
(602) 615-0381
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
4975
AZ
103TM1800X
Intellectual & Developmental Disabilities Psychologist
—
—
Other
Enumeration date
06/19/2018
Last updated
06/19/2018
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