Provider Demographics
NPI:1861682080
Name:ALBRECHT, PATRICIA LOUISE (MA)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:LOUISE
Last Name:ALBRECHT
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 210
Mailing Address - Street 2:14200 W. KIRKLAND HILLSIDE RD.
Mailing Address - City:KIRKLAND
Mailing Address - State:AZ
Mailing Address - Zip Code:86332-0210
Mailing Address - Country:US
Mailing Address - Phone:928-442-3258
Mailing Address - Fax:928-442-9488
Practice Address - Street 1:8501 E YAVAPAI RD
Practice Address - Street 2:
Practice Address - City:PRESCOTT VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86314-8622
Practice Address - Country:US
Practice Address - Phone:928-771-3544
Practice Address - Fax:928-771-3549
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-25
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool