Organization
MENTAL EDGE NEUROPSYCHOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN W DENBOER PH.D. (NEUROPSYCHOLOGIST)
(602) 510-9217
Entity
Organization
Contact information
Practice address
16838 E PALISADES BLVD, SUITE C153, FOUNTAIN HILLS, AZ 85268-3786
(602) 510-9217
Mailing address
PO BOX 967, PHOENIX, AZ 85001-0967
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
4026
AZ
Other
Enumeration date
07/28/2015
Last updated
07/28/2015
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