MEDICARE: RODOLFO ARVIZU

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
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1972017366
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RODOLFO ARVIZU

Provider Business Mailing Address
First Line	:	169 WESTWIND DR
Second Line	:
City	:	AVON LAKE
State	:	OH
Zip	:	44012-2406
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3100 E 45TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44127-1088
Country	:	US
Telephone Number	:	216-341-5510
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/22/2017
Last Update Date	:	11/22/2017

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Directions to “ RODOLFO ARVIZU ” Practice Location

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