Healthcare Provider Details

I. General information

NPI: 1013825959
Provider Name (Legal Business Name): KATHRINE ANN MAYER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6565 E CARONDELET DR STE 215
TUCSON AZ
85710-3533
US

IV. Provider business mailing address

3101 N CENTRAL AVE STE 500
PHOENIX AZ
85012-2639
US

V. Phone/Fax

Practice location:
  • Phone: 602-230-7373
  • Fax: 520-231-9686
Mailing address:
  • Phone: 602-230-7373
  • Fax: 602-682-7455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLAC-24018
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: