Healthcare Provider Details

I. General information

NPI: 1306750336
Provider Name (Legal Business Name): HALEY GRACE FIEGER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5333 N 7TH ST STE B219
PHOENIX AZ
85014-2814
US

IV. Provider business mailing address

805 E EUGIE AVE
PHOENIX AZ
85022-4820
US

V. Phone/Fax

Practice location:
  • Phone: 602-525-6049
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLAMFT10877
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: