Provider Demographics
NPI:1710167663
Name:BILL RETTS PHD PC
Entity Type:Organization
Organization Name:BILL RETTS PHD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:L
Authorized Official - Last Name:RETTS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:602-997-1075
Mailing Address - Street 1:801 W BUTLER DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-4454
Mailing Address - Country:US
Mailing Address - Phone:602-997-1075
Mailing Address - Fax:602-354-7503
Practice Address - Street 1:11024 N 28TH DR STE 290
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029-4373
Practice Address - Country:US
Practice Address - Phone:602-870-7710
Practice Address - Fax:602-734-0692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-08
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty