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Arizona Neuropsychological Services, Placate: PATIENT INFORMATION NAME BIRTHDATE SEX: M F ADDRESS CITY STATE ZIP HOME PHONE CELL PHONE EMAIL SOCIAL SECURITY # MARITAL STATUS PRIMARY LANGUAGE RELIGION
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Follow the specific sections or categories provided in the forms to provide detailed information about your medical history, any previous neuropsychological tests or evaluations, and any current symptoms or concerns you may have.
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Arizona Neuropsychological Services PLLC is a professional limited liability company that provides neuropsychological evaluations, assessments, and therapeutic services to individuals with various cognitive and emotional issues.
Professionals who operate a neuropsychological practice as a PLLC in Arizona are required to file for Arizona Neuropsychological Services PLLC.
To fill out the Arizona Neuropsychological Services PLLC forms, gather necessary information about your practice, complete the appropriate state forms, provide required documentation, and submit them to the Arizona Corporation Commission.
The purpose of Arizona Neuropsychological Services PLLC is to create a legally recognized entity for practicing neuropsychology, ensuring compliance with state laws and regulations while providing high-quality mental health services.
Information that must be reported includes the name of the PLLC, designated agent for service of process, principal office address, and the names and addresses of the members or managers of the PLLC.
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