Healthcare Provider Details

I. General information

NPI: 1578713194
Provider Name (Legal Business Name): KATRINA SAENZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2008
Last Update Date: 09/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16750 W GARFIELD ST
GOODYEAR AZ
85338-6287
US

IV. Provider business mailing address

16750 W GARFIELD ST
GOODYEAR AZ
85338-6287
US

V. Phone/Fax

Practice location:
  • Phone: 623-772-4700
  • Fax: 623-772-4720
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number3355716
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: