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General NPI Number Information
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NPI Number | 1124811765
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Entity Type | Individual
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Provider Name | RACHEL ELIZABETH KOLLWITZ LIAC, LCDC
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Gender | Female
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Dates
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Enumeration Date | 05/27/2025
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 4755 CAMPUS DR
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City | SIERRA VISTA
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State | AZ
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Zip | 85635-2449
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Country | US
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Telephone | 520-458-3932
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Fax |
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Provider Business Mailing Address
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Address Line | 1941 N SANDERS RD
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City | HUACHUCA CITY
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State | AZ
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Zip | 85616-8101
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Country | US
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Telephone | 210-803-1405
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Fax |
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 15725
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 155363
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License Number State | AZ
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