Provider Demographics
NPI:1578627311
Name:SZABO, RENA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:RENA
Middle Name:
Last Name:SZABO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10304 E ROSEMARY LN
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-8678
Mailing Address - Country:US
Mailing Address - Phone:630-774-0177
Mailing Address - Fax:
Practice Address - Street 1:10403 E. ROSEMARY LANE
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-8678
Practice Address - Country:US
Practice Address - Phone:630-774-0177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071-006982103TC0700X
AZ4355103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical