Individual
MARY T. BUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D., PSY.N.P.
Contact information
Practice address
6630 N 47TH AVE, STE 6, GLENDALE, AZ 85301-4172
(602) 957-2710
(623) 934-5895
Mailing address
6630 N 47TH AVE, STE 6, GLENDALE, AZ 85301-4172
(602) 957-2710
(623) 934-5895
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1909
AZ
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
AP2219
AZ
Other
Enumeration date
09/07/2005
Last updated
01/09/2008
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