Provider Demographics
NPI:1750862264
Name:FOCUS NEUROPSYCHOLOGY AZ, PLLC
Entity Type:Organization
Organization Name:FOCUS NEUROPSYCHOLOGY AZ, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL NEUROPSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:RUMBLE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:623-295-9119
Mailing Address - Street 1:530 E MCDOWELL RD STE 107-427
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85004-1549
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2400 N CENTRAL AVE STE 204
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85004-1341
Practice Address - Country:US
Practice Address - Phone:623-295-9119
Practice Address - Fax:888-819-1123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-22
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4108103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty