Healthcare Provider Details

I. General information

NPI: 1245956127
Provider Name (Legal Business Name): ARIANNA MARIE SAENZ-OCHOA LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2022
Last Update Date: 12/16/2023
Certification Date: 12/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17235 N 75TH AVE STE F100
GLENDALE AZ
85308-0871
US

IV. Provider business mailing address

8503 W BLUEFIELD AVE
PEORIA AZ
85382-8046
US

V. Phone/Fax

Practice location:
  • Phone: 480-641-1165
  • Fax:
Mailing address:
  • Phone: 623-298-9339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLAC-22581
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: