Provider Demographics
NPI:1043452303
Name:SOUTHWEST ADULT ASPERGERS ASSOCIATION
Entity Type:Organization
Organization Name:SOUTHWEST ADULT ASPERGERS ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:NICHOLS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:520-743-9789
Mailing Address - Street 1:5010 W SWEETWATER DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85745-9064
Mailing Address - Country:US
Mailing Address - Phone:520-743-9789
Mailing Address - Fax:520-743-1577
Practice Address - Street 1:5010 W SWEETWATER DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85745-9064
Practice Address - Country:US
Practice Address - Phone:520-743-9789
Practice Address - Fax:520-743-1577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-01
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3378251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health