Individual
DR. JOHN PHILIP DIBACCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
11811 N TATUM BLVD, P115, PHOENIX, AZ 85028-1614
(602) 953-6165
Mailing address
11811 N TATUM BLVD, P115, PHOENIX, AZ 85028-1614
(602) 953-6165
Taxonomy
Speciality
Code
Description
License number
State
103TF0200X
Forensic Psychologist
131
NV
103TF0200X
Forensic Psychologist
Primary
524
AZ
Other
Enumeration date
07/23/2009
Last updated
07/23/2009
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