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Individual

ADAM ROBERT GODFREY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
SSP, NASP

Contact information

Practice address
13801 E BENSON HWY, VAIL, AZ 85641-9074
(520) 879-2440
Mailing address
13801 E BENSON HWY, VAIL, AZ 85641-9074
(520) 879-2440

Taxonomy

Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
3690822
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
968224
AZ
Enumeration date
05/10/2007
Last updated
07/09/2007
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