| Organization Name: | NORTHERN ARIZONA MED-PSYCH CLINIC, PLLC |
| NPI Number: | 1588061634 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LINDA COLLEEN TOLLESON (CO-OWNER) |
| Mailing Address: | 2155 W Sr 89a St 105 Sedona |
| State: | AZ US |
| Postal Code: | 863365468 |
| Phone Number: | 9288213403 |
| Fax Number: | 9282821852 |
| NPI Enumeration Date: | 12/03/2014 |
| NPI Last Update Date: | 11/10/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 36928 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | AZ |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |