Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | ||
N | 101YM0800X | Mental Health Counselor | ||
N | 102L00000X | Psychologist | ||
N | 103T00000X | Psychologist | ||
N | 103K00000X | Behavior Analyst | ||
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | ||
N | 103TB0200X | Cognitive & Behavioral Psychologist | ||
N | 103TC1900X | Counseling Psychologist | ||
N | 103TC2200X | Clinical Child & Adolescent Psychologist | ||
N | 103TP0016X | Prescribing (Medical) | ||
N | 103TP0814X | Psychoanalysis | ||
N | 103TP2701X | Group Psychotherapist | ||
N | 104100000X | Social Worker |
NPI | 1467110676 |
---|---|
Provider Name | Kedha Alce |
First Address | Phoenix, AZ 85021-5281 |
Second Address | Phoenix, AZ 85021-5281 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2021 |
Last Update Date | 21/12/2021 |