Provider Demographics
NPI:1588845135
Name:GLORIA M COCHRAN PHD PLC
Entity Type:Organization
Organization Name:GLORIA M COCHRAN PHD PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:COCHRAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-272-9184
Mailing Address - Street 1:9590 E IRONWOOD SQUARE DR STE 201
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4599
Mailing Address - Country:US
Mailing Address - Phone:480-272-9184
Mailing Address - Fax:480-219-2390
Practice Address - Street 1:9590 E IRONWOOD SQUARE DR STE 201
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4599
Practice Address - Country:US
Practice Address - Phone:480-272-9184
Practice Address - Fax:480-219-2390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-23
Last Update Date:2007-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ107293Medicare PIN