Nellie Christine Durham, MA
Individual provider Active NPI School Psychologist · Mesa, AZ
NPI 1598896490 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1598896490
- Entity type
- Individual (NPI type 1)
- Primary specialty
- School Psychologist 103TS0200X
- Practice address
- 1025 N Country Club Dr
Mesa, AZ 85201-3307 - Phone
- (480) 472-0502
- Fax
- (480) 472-0705
- NPI assigned
- Mar 9, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | Yes |
Addresses
Primary practice location
1025 N Country Club Dr
Mesa, AZ 85201-3307
Mailing address
1025 N Country Club Dr
Mesa, AZ 85201-3307
Phone (480) 472-0502
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 805583 | Medicaid | AZ |
Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.