Healthcare Provider Details

I. General information

NPI: 1376306381
Provider Name (Legal Business Name): ELIZABETH OCHOA LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2024
Last Update Date: 02/01/2024
Certification Date: 02/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1246 E THOMAS DR
CASA GRANDE AZ
85122-1256
US

IV. Provider business mailing address

1246 E THOMAS DR
CASA GRANDE AZ
85122-1256
US

V. Phone/Fax

Practice location:
  • Phone: 602-756-6663
  • Fax:
Mailing address:
  • Phone: 602-756-6663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC-22668
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: