Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TB0200X | Cognitive & Behavioral Psychologist | 4654 | AZ |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 4654 | AZ |
Y | 103TS0200X | School Psychologist | 4654 | AZ |
NPI | 1013385384 |
---|---|
Provider Name | Dr. Ashley Michelle Loeb |
First Address | Phoenix, AZ 85048-0556 |
Second Address | Phoenix, AZ 85048-0556 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/09/2015 |
Last Update Date | 03/09/2015 |