Provider Demographics
NPI:1518190537
Name:PINNELL, MICHAEL J (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:PINNELL
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Gender:M
Credentials:PSYD
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Mailing Address - Street 1:8766 E. HWY 69
Mailing Address - Street 2:C/O DONNA THAXTON HUMBOLDT UNIFIED SCHOOL DISTRICT/SSO
Mailing Address - City:PRESCOTT VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86314
Mailing Address - Country:US
Mailing Address - Phone:928-759-4042
Mailing Address - Fax:928-759-4030
Practice Address - Street 1:8766 E. HWY 69
Practice Address - Street 2:C/O DONNA THAXTON HUMBOLDT UNIFIED SCHOOL DISTRICT/SSO
Practice Address - City:PRESCOTT VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86314
Practice Address - Country:US
Practice Address - Phone:928-759-4042
Practice Address - Fax:928-759-4030
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-25
Last Update Date:2009-08-25
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool