Healthcare Provider Details

I. General information

NPI: 1801726302
Provider Name (Legal Business Name): ZONA ROSE HEALING ARTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10207 E SHADY ROCK LN
TUCSON AZ
85749-8162
US

IV. Provider business mailing address

10207 E SHADY ROCK LN
TUCSON AZ
85749-8162
US

V. Phone/Fax

Practice location:
  • Phone: 520-631-2067
  • Fax:
Mailing address:
  • Phone: 520-631-2067
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL J WAGNER
Title or Position: PSYCHOLOGIST
Credential: PHD
Phone: 520-631-2067