Organization
SHELLEY S KAUFMAN PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHELLEY KAUFMAN PH.D. (PRESIDENT)
(602) 257-0560
Entity
Organization
Contact information
Practice address
17505 N 79TH AVE, SUITE 315, GLENDALE, AZ 85308-8725
(602) 257-0560
Mailing address
PO BOX 10863, GLENDALE, AZ 85318-0863
(602) 257-0560
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1389
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZPHD1389
PTAN
AZ
Enumeration date
07/12/2016
Last updated
11/06/2017
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