Individual
MICHAEL JOSEPH REDIVO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
4229 N 16TH ST, PHOENIX, AZ 85016-5318
(602) 277-4482
(602) 277-4483
Mailing address
4229 N 16TH ST, PHOENIX, AZ 85016-5318
(602) 277-4482
(602) 277-4483
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
3433
AZ
Other
Enumeration date
10/29/2008
Last updated
10/29/2008
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