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Individual

MS. PHYLLIS ANN GROSSMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.C.

Contact information

Practice address
2345 E THOMAS RD, SUITE 360, PHOENIX, AZ 85016-7848
(602) 468-2077
(480) 609-9688
Mailing address
5929 E CHARTER OAK RD, SCOTTSDALE, AZ 85254-4348
(602) 410-6635
(480) 609-9552

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC1814
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
964561
AHCCS PROVIDER ID
AZ
Enumeration date
01/19/2007
Last updated
07/08/2007
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