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General NPI Number Information
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NPI Number | 1104804988
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Entity Type | Organization
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Legal Business Name | H2CHANGE LLC
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Dates
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Enumeration Date | 01/03/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1865 PASEO SAN LUIS STE B
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City | SIERRA VISTA
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State | AZ
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Zip | 85635
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Country | US
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Telephone | 520-417-2055
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Fax | 520-417-2055
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Provider Business Mailing Address
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Address Line | 1865 PASEO SAN LUIS STE B
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City | SIERRA VISTA
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State | AZ
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Zip | 85635
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Country | US
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Telephone | 520-417-2055
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Fax | 520-417-2055
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | MS. TONI MARIE LEO
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Credential | PHD
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Telephone | 520-417-2055
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 3296
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 103TH0100X
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Taxonomy Name | Health Service Psychologist
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License Number | 3296
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License Number State | AZ
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