Organization
PROFESSIONAL PSYCHOLOGY ASSOCIATES, PC
Active
Parent organization
PROFESSIONAL PSYCHLOGY ASSOCIATES, PC
Other names
Center for Lifestyle Change
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROFESSIONAL PSYCHLOGY ASSOCIATES, PC
Authorized official
DR. PHILLIP D LETT PHD (ADMINISTRATOR/PRESIDENT)
(602) 852-0911
Entity
Organization
Contact information
Practice address
4222 E CAMELBACK RD, SUITE H230, PHOENIX, AZ 85018-2745
(602) 852-0911
(602) 852-0632
Mailing address
4222 E CAMELBACK ROAD, SUITE H230, PHOENIX, AZ 85018-2787
(602) 852-0911
(602) 852-0632
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
BH934
AZ
Other
Enumeration date
05/01/2007
Last updated
06/12/2008
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