Provider Demographics
NPI:1760650683
Name:DYNAMIC MASTERY, INC
Entity Type:Organization
Organization Name:DYNAMIC MASTERY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HESS
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:520-888-9338
Mailing Address - Street 1:6465 E RED CLOUD DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85750-1914
Mailing Address - Country:US
Mailing Address - Phone:520-888-9338
Mailing Address - Fax:520-722-0448
Practice Address - Street 1:5920 E PIMA ST
Practice Address - Street 2:SUITE 150
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-4306
Practice Address - Country:US
Practice Address - Phone:520-888-9338
Practice Address - Fax:520-722-0448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-13
Last Update Date:2011-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN032221101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ43384Medicaid
AZ43384Medicaid