Healthcare Provider Details

I. General information

NPI: 1285328435
Provider Name (Legal Business Name): MARIA DEL CARMEN CHASEYOUNG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2023
Last Update Date: 06/08/2023
Certification Date: 06/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7080 N 19TH AVE
PHOENIX AZ
85021-8585
US

IV. Provider business mailing address

725 E GRANADA RD
PHOENIX AZ
85006-2149
US

V. Phone/Fax

Practice location:
  • Phone: 602-601-2401
  • Fax:
Mailing address:
  • Phone: 602-373-6547
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number05156
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: