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General NPI Number Information
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NPI Number | 1063549764
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Entity Type | Individual
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Provider Name | BETTY BIZAHALONI LCSW
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Gender | Female
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | NAVAJO ROUTE 4
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City | PINON
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State | AZ
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Zip | 86510
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Country | US
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Telephone | 928-674-7001
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Fax | 928-674-7705
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Provider Business Mailing Address
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Address Line | PO DRAWER PH
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City | CHINLE
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State | AZ
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Zip | 86503
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Country | US
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Telephone | 928-674-7001
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Fax | 928-674-7705
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW-0384
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License Number State | AZ
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