Individual
NATALIA KAZAKOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, PSYD
Contact information
Practice address
11221 N 28TH DRIVE BUILDING E, PHOENIX, AZ 85029-4218
(602) 316-0724
Mailing address
1616 N CENTRAL AVENUE, PHOENIX, AZ 85004
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
PSY-005610
AZ
103TC0700X
Clinical Psychologist
Primary
PSY-005610
AZ
Other
Enumeration date
08/14/2016
Last updated
11/01/2023
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