Individual
KEDHA ALCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8330 N 19TH AVE APT 3083, PHOENIX, AZ 85021-5281
(602) 706-0328
Mailing address
8330 N 19TH AVE APT 3083, PHOENIX, AZ 85021-5281
(602) 706-0328
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
102L00000X
Psychoanalyst
—
—
103K00000X
Behavior Analyst
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC1900X
Counseling Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TP0016X
Prescribing (Medical) Psychologist
—
—
103TP0814X
Psychoanalysis Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
104100000X
Social Worker
—
—
171M00000X
Case Manager/Care Coordinator
—
—
172A00000X
Driver
—
—
251B00000X
Case Management Agency
—
—
Other
Enumeration date
12/05/2021
Last updated
12/21/2021
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