Doctor Name: | DR. BRETT VIVIAN PRINCE |
NPI Number: | 1508159245 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | 4127 |
Business Practice Address: | 249 W. Ponderosa Whiteriver, AZ - 85941 |
Business Phone Number: | 9283384811 |
Business Fax Number: | |
Mailing Address: | Po Box 1089, WHITERIVER |
State: | AZ |
Postal Code: | 859411089 |
Phone Number: | 9283384811 |
Fax Number: | |
NPI Enumeration Date: | 05/26/2011 |
NPI Last Update Date: | 05/26/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TS0200X |
License Number: | 4127 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | School |
Taxonomy Definition: |