Provider Demographics
NPI:1720031206
Name:MACGREGOR, JANET C (PHD)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:C
Last Name:MACGREGOR
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:C
Other - Last Name:BROOKFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 32572
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85751-2572
Mailing Address - Country:US
Mailing Address - Phone:520-760-0338
Mailing Address - Fax:520-760-0338
Practice Address - Street 1:10957 EAST MESQUITE VALLEY TRAIL
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85749-6710
Practice Address - Country:US
Practice Address - Phone:520-760-0338
Practice Address - Fax:520-760-0338
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1443103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ76526Medicare PIN