Provider Demographics
NPI:1497487912
Name:PSYCHOLOGY PRACTICE OF JUDITH RAND PHD PLC
Entity Type:Organization
Organization Name:PSYCHOLOGY PRACTICE OF JUDITH RAND PHD PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:RAND
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:480-466-7010
Mailing Address - Street 1:1845 S DOBSON RD STE 106
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-5662
Mailing Address - Country:US
Mailing Address - Phone:480-466-7010
Mailing Address - Fax:480-219-5254
Practice Address - Street 1:1845 S DOBSON RD STE 106
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-5662
Practice Address - Country:US
Practice Address - Phone:480-466-7010
Practice Address - Fax:480-219-5254
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-24
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty