Healthcare Provider Details

I. General information

NPI: 1689130205
Provider Name (Legal Business Name): ALLISON MUSSER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2019
Last Update Date: 02/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4425 W OLIVE AVE STE 194
GLENDALE AZ
85302-3853
US

IV. Provider business mailing address

618 S MADISON DR
TEMPE AZ
85281-7248
US

V. Phone/Fax

Practice location:
  • Phone: 480-784-1514
  • Fax: 623-915-2099
Mailing address:
  • Phone: 480-784-1514
  • Fax: 623-915-2099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLPC-16034
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: