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NPI Code Detail

MEDICARE: BENJAMIN AYANTOLA LPC

MEDICARE: BENJAMIN AYANTOLA LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor18123AZ

General Provider Information

NPI Number : 1902445869
Entity Type Code : Individual
Provider Name (Legal Business Name) : BENJAMIN AYANTOLA LPC
Provider Business Mailing Address
First Line : 6700 N ORACLE RD STE 411
Second Line :
City : TUCSON
State : AZ
Zip : 85704-7734
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6700 N ORACLE RD STE 412
Second Line :
City : TUCSON
State : AZ
Zip : 85704-7734
Country : US
Telephone Number : 860-689-4660
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/24/2019
Last Update Date : 12/24/2019

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Directions to “ BENJAMIN AYANTOLA LPC” Practice Location

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