Provider Demographics
NPI:1114069234
Name:SOUTHWEST NEUROPSYCHOLOGY ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:SOUTHWEST NEUROPSYCHOLOGY ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHANNAH
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:BIGGAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:520-320-6230
Mailing Address - Street 1:2650 N WYATT DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-6106
Mailing Address - Country:US
Mailing Address - Phone:520-320-6230
Mailing Address - Fax:520-322-3665
Practice Address - Street 1:2650 N WYATT DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-6106
Practice Address - Country:US
Practice Address - Phone:520-320-6230
Practice Address - Fax:520-322-3665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZCK7219OtherMEDICARE RAILROAD
AR740797Medicaid
AZCK7219OtherMEDICARE RAILROAD