Healthcare Provider Details

I. General information

NPI: 1134880685
Provider Name (Legal Business Name): EMILY O'BRIEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2022
Last Update Date: 11/01/2025
Certification Date: 11/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2532 W PEORIA AVE
PHOENIX AZ
85029-4709
US

IV. Provider business mailing address

9201 N 25TH AVE STE 185
PHOENIX AZ
85021-2717
US

V. Phone/Fax

Practice location:
  • Phone: 480-217-3147
  • Fax:
Mailing address:
  • Phone: 480-217-3147
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: