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Individual

BRIAN BANTEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
9375 E SHEA BLVD STE 100, SCOTTSDALE, AZ 85260-6986
(480) 992-4996
(480) 878-3770
Mailing address
9375 E SHEA BLVD STE 100, SCOTTSDALE, AZ 85260-6986
(480) 992-4996
(480) 878-3770

Taxonomy

Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
PSY-005364
AZ
103TB0200X
Cognitive & Behavioral Psychologist
PSY-005364
AZ
103TC0700X
Clinical Psychologist
Primary
PSY-005364
AZ
103TC2200X
Clinical Child & Adolescent Psychologist
PSY-005364
AZ

Other

Enumeration date
08/02/2016
Last updated
01/11/2024
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