Individual
BRIAN SEWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
13801 E BENSON HWY, VAIL, AZ 85641-9074
(520) 879-2052
Mailing address
PO BOX 800, 13801 E. BENSON HIGHWAY, VAIL, AZ 85641-0800
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
4256236
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
897001
—
AZ
Enumeration date
08/19/2010
Last updated
08/19/2010
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