Provider Demographics
NPI:1710495726
Name:ISHIKAWA, MICHELE ELIZABETH (PHD)
Entity type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:ELIZABETH
Last Name:ISHIKAWA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4904 S POWER RD STE 103-220
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85212-3609
Mailing Address - Country:US
Mailing Address - Phone:480-690-9111
Mailing Address - Fax:480-781-4797
Practice Address - Street 1:20 E THOMAS RD STE 2200
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-3133
Practice Address - Country:US
Practice Address - Phone:480-690-9111
Practice Address - Fax:480-781-4797
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-12
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ4904103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist