Provider Demographics
NPI:1598897340
Name:STRICKLAND, IAN MARCUS (PSYD)
Entity Type:Individual
Prefix:DR
First Name:IAN
Middle Name:MARCUS
Last Name:STRICKLAND
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17235 N 75TH AVE
Mailing Address - Street 2:SUITE E-170
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-0831
Mailing Address - Country:US
Mailing Address - Phone:602-561-0920
Mailing Address - Fax:623-486-1636
Practice Address - Street 1:17235 N 75TH AVE
Practice Address - Street 2:SUITE E-170
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-0831
Practice Address - Country:US
Practice Address - Phone:602-561-0920
Practice Address - Fax:623-486-1636
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3865103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical