Organization Name: | FAMILY RESOURCE CENTER 0384 |
NPI Number: | 1316083728 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DENNIS E. BROADBENT (PSYCHOLOGIST (DIRECTOR)) |
Mailing Address: | 2432 W, Peoria Avenue Suite 1327 Phoenix |
State: | AZ US |
Postal Code: | 85029 |
Phone Number: | 6028663432 |
Fax Number: | 6028663764 |
NPI Enumeration Date: | 01/30/2007 |
NPI Last Update Date: | 06/11/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | LPC2693 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | AZ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |