MICHAEL DALE FIDLER


Address: 1158 E Hackamore St, Mesa, AZ 85203-4333
Phone: 4805234840

MICHAEL DALE FIDLER (NPI# 1578753315) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1578753315
Entity Type Individual
Full Name MICHAEL DALE FIDLER
Credential EDD
Practice Address 1158 E Hackamore St
Mesa
AZ 85203-4333
Practice Telephone 4805234840
Mailing Telephone 4805234840
Enumeration Date 2007-07-27
Last Update Date 2007-08-29
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103TS0200X Psychologist
Specialization: School
AZ Behavioral Health & Social Service Providers

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Office Location

Street Address 1158 E HACKAMORE ST
City MESA
State AZ
Zip Code 85203-4333

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Taxonomy Information

Taxonomy Code 103TS0200X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization School

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1508378209 Shanna Schopmeyer Psychologist 9646 E Baltimore St, Mesa, AZ 85207-8030 2017-11-02
1063806354 Shannon Follett Psychologist 10020 E Isleta Ave, Mesa, AZ 85209-7783 2015-03-24
1326356221 Todd Mckay Psychologist 2055 S Rogers, Mesa, AZ 85202-6524 2010-09-14
1720394042 Kerry Rae Williams Psychologist 738 S Longmore, Mesa, AZ 85202-1908 2010-08-24
1639300098 Heather Hynes Psychologist 4831 E Dixon St, Mesa, AZ 85205-6456 2009-08-03
1255562120 Steven Casamento Psychologist 1710 S Gilbert Rd, Apt 1090, Mesa, AZ 85204-8031 2009-07-27
1871749846 Gg Heintz-jacobs Psychologist 2940 E Broadway Rd, #231, Mesa, AZ 85204-1751 2008-08-11
1851517833 Bonnie Jean Bartol Psychologist 705 S 32nd St, Mesa Public Schools Taylor Jr High, Mesa, AZ 85204 2007-04-18
1669514329 Elizabeth Danielson Psychologist 3120 N Red Mountain, Mesa, AZ 85207-1068 2007-02-12
1033250675 David S Conroy Psychologist 1313 W Medina Ave, Mesa, AZ 85202-6610 2007-02-08
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Competitor

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City MESA
Zip Code 85203

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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