Doctor Name: | PHILIP NICE |
NPI Number: | 1699833624 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW, LISAC |
License Number: | LISAC-1597 |
Business Practice Address: | 980 E. Mt. Lemon Road Oracle, AZ - 85623 |
Business Phone Number: | 4809830065 |
Business Fax Number: | 4802885339 |
Mailing Address: | Po Box 3160, APACHE JUNCTION |
State: | AZ |
Postal Code: | 852173160 |
Phone Number: | 4809830065 |
Fax Number: | 4802885339 |
NPI Enumeration Date: | 12/04/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | LISAC-1597 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | AZ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |