Healthcare Provider Details
I. General information
NPI: 1225255284
Provider Name (Legal Business Name): MRS. MARIANN ARCARI RUBIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/19/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7254 E SOUTHERN AVE SUITE 123
MESA AZ
85209-2786
US
IV. Provider business mailing address
11309 E PETRA AVE
MESA AZ
85212-1981
US
V. Phone/Fax
- Phone: 480-380-6248
- Fax: 480-986-2618
- Phone: 480-380-6248
- Fax: 480-986-2618
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | AZ11566 |
| License Number State | AZ |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | 107699734 |
| Identifier Type | OTHER |
| Identifier State | AZ |
| Identifier Issuer | UNITED HEALTHCARE |
| # 2 | |
| Identifier | 12042 |
| Identifier Type | OTHER |
| Identifier State | AZ |
| Identifier Issuer | VALUE OPTIONS |
| # 3 | |
| Identifier | 204432 |
| Identifier Type | OTHER |
| Identifier State | AZ |
| Identifier Issuer | MHN |
| # 4 | |
| Identifier | 2016596 |
| Identifier Type | OTHER |
| Identifier State | AZ |
| Identifier Issuer | CIGNA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: