Healthcare Provider Details

I. General information

NPI: 1639084551
Provider Name (Legal Business Name): ANITZA MILIC ANGEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

335 N ALMA SCHOOL RD
CHANDLER AZ
85224-4363
US

IV. Provider business mailing address

1900 S OAK ST
GILBERT AZ
85233-8964
US

V. Phone/Fax

Practice location:
  • Phone: 480-641-1165
  • Fax:
Mailing address:
  • Phone: 754-267-9475
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: