Provider Demographics
NPI:1336834555
Name:HUISH, REXX EDWARD
Entity Type:Individual
Prefix:
First Name:REXX
Middle Name:EDWARD
Last Name:HUISH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36275 N GANTZEL RD STE 102
Mailing Address - Street 2:
Mailing Address - City:SAN TAN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85140-7320
Mailing Address - Country:US
Mailing Address - Phone:480-590-7147
Mailing Address - Fax:480-597-3495
Practice Address - Street 1:36275 N GANTZEL RD STE 102
Practice Address - Street 2:
Practice Address - City:SAN TAN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85140-7320
Practice Address - Country:US
Practice Address - Phone:480-590-7147
Practice Address - Fax:480-597-3495
Is Sole Proprietor?:No
Enumeration Date:2023-04-05
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health