Provider Demographics
NPI:1831188176
Name:TANSY, MICHAEL EDWARD (PHD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:EDWARD
Last Name:TANSY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3681 E BASELINE RD
Mailing Address - Street 2:SUITE 222
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-2647
Mailing Address - Country:US
Mailing Address - Phone:480-966-9337
Mailing Address - Fax:480-704-5181
Practice Address - Street 1:3681 E BASELINE RD
Practice Address - Street 2:SUITE 222
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-2647
Practice Address - Country:US
Practice Address - Phone:480-966-9337
Practice Address - Fax:480-704-5181
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3285103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist