Individual
MARVIN JIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11221 N 28TH DR BLDG E, PHOENIX, AZ 85029-5615
(602) 997-2233
Mailing address
11221 N 28TH DR BLDG E, PHOENIX, AZ 85029-5615
(602) 997-2223
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
12/02/2022
Last updated
12/02/2022
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