Provider Demographics
NPI:1780004382
Name:PRINCIOTTA, DANA KRISTINA (PHD)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:KRISTINA
Last Name:PRINCIOTTA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1845 W ORANGE GROVE RD STE 111
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-1196
Mailing Address - Country:US
Mailing Address - Phone:520-329-8298
Mailing Address - Fax:520-329-8311
Practice Address - Street 1:1845 W ORANGE GROVE RD STE 111
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-1196
Practice Address - Country:US
Practice Address - Phone:520-329-8298
Practice Address - Fax:520-329-8311
Is Sole Proprietor?:No
Enumeration Date:2014-04-22
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4440103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist