Provider Demographics
NPI:1497130900
Name:WESTBROOK, TAJH
Entity Type:Individual
Prefix:
First Name:TAJH
Middle Name:
Last Name:WESTBROOK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 S LA ARBOLETA ST
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296-1129
Mailing Address - Country:US
Mailing Address - Phone:480-266-9156
Mailing Address - Fax:
Practice Address - Street 1:126 S LA ARBOLETA ST
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-1129
Practice Address - Country:US
Practice Address - Phone:480-266-9156
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-26
Last Update Date:2015-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst