Healthcare Provider Details

I. General information

NPI: 1083945489
Provider Name (Legal Business Name): DONNA DENISE APODACA LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2010
Last Update Date: 01/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3260 N HAYDEN RD 101
SCOTTSDALE AZ
85251-6649
US

IV. Provider business mailing address

3260 N HAYDEN RD 101
SCOTTSDALE AZ
85251-6649
US

V. Phone/Fax

Practice location:
  • Phone: 480-804-0326
  • Fax: 480-804-0083
Mailing address:
  • Phone: 480-804-0326
  • Fax: 480-804-0083

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1433
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: