Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 4495 | AZ |
Y | 103TC0700X | Clinical Psychologist | 4495 | AZ |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 4495 | AZ |
N | 103TA0700X | Adult Development & Aging Psychologist | 4495 | AZ |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 4495 | AZ |
N | 103G00000X | Clinical Psychologist | 4495 | AZ |
N | 103TC0700X | Clinical Psychologist | 4495 | AZ |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 4495 | AZ |
N | 103TF0000X | Family Psychologist | 4495 | AZ |
N | 103TF0200X | Forensic Psychologist | 4495 | AZ |
N | 103TH0004X | Health Psychologist | 4495 | AZ |
N | 103TP2701X | Group Psychotherapist | 4495 | AZ |
N | 103TR0400X | Rehabilitation Psychologist | 4495 | AZ |
NPI | 1801206115 |
---|---|
Provider Name | Dr. Konstantinos D. Thomopoulos |
First Address | Scottsdale, AZ 85266-1567 |
Second Address | Scottsdale, AZ 85266-1567 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2014 |
Last Update Date | 08/05/2014 |