Provider Demographics
NPI:1114310117
Name:ANDERSON, DANA LEIGH (PHD)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:LEIGH
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:LEIGH
Other - Last Name:SMIDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:7047 E GREENWAY PKWY
Mailing Address - Street 2:SUITE 250
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-8107
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7047 E GREENWAY PKWY
Practice Address - Street 2:SUITE 250
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-8107
Practice Address - Country:US
Practice Address - Phone:480-659-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-15
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4904103TC0700X
NY021009103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical