Provider Demographics
NPI:1174663348
Name:GREENBAUM, ALAN LEBLANG (PHD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:LEBLANG
Last Name:GREENBAUM
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8505 E VALLEY VIEW RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85250-6768
Mailing Address - Country:US
Mailing Address - Phone:480-484-5077
Mailing Address - Fax:
Practice Address - Street 1:6720 E CONTINENTAL DR
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85257-3226
Practice Address - Country:US
Practice Address - Phone:480-484-5828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool