Doctor Name: | DR. AUDREY A KANWISCHER |
NPI Number: | 1093791568 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | D.O. |
License Number: | 3744 |
Business Practice Address: | 483 W. Seed Farm Rd. Sacaton, AZ - 85247 |
Business Phone Number: | 6025281340 |
Business Fax Number: | 6025281296 |
Mailing Address: | Po Box 115, SACATON |
State: | AZ |
Postal Code: | 852470115 |
Phone Number: | 6025281340 |
Fax Number: | 6025281296 |
NPI Enumeration Date: | 12/16/2005 |
NPI Last Update Date: | 02/08/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2084P0804X |
License Number: | 3744 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Psychiatry & Neurology |
Taxonomy Specialization: | Child & Adolescent Psychiatry |
Taxonomy Definition: | Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |