Provider Demographics
NPI:1336328806
Name:A POSITIVE OUTCOME NEUROPSYCHOLOGY SERVICES PLLC
Entity Type:Organization
Organization Name:A POSITIVE OUTCOME NEUROPSYCHOLOGY SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL NEUROPSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:623-512-8021
Mailing Address - Street 1:7227 N 16TH ST
Mailing Address - Street 2:SUITE 222
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-5251
Mailing Address - Country:US
Mailing Address - Phone:623-512-8021
Mailing Address - Fax:623-825-6784
Practice Address - Street 1:7227 N 16TH ST
Practice Address - Street 2:SUITE 222
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-5251
Practice Address - Country:US
Practice Address - Phone:623-512-8021
Practice Address - Fax:623-825-6784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-31
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3573103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty