Healthcare Provider Details

I. General information

NPI: 1346150570
Provider Name (Legal Business Name): BRIANNA HUMBERT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9768 E CARR PEAK TRL
TUCSON AZ
85747-0195
US

IV. Provider business mailing address

9768 E CARR PEAK TRL
TUCSON AZ
85747-0195
US

V. Phone/Fax

Practice location:
  • Phone: 520-756-6220
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLMSW-23008
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: