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General NPI Number Information
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NPI Number | 1164836664
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Entity Type | Organization
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Legal Business Name | ANEWAY COUNSELING, PLLC
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Dates
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Enumeration Date | 06/12/2014
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Last Update Date | 06/12/2014
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Provider Practice Location Address
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Address Line | 3795 W 22ND LN STE 14
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City | YUMA
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State | AZ
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Zip | 85364-9266
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Country | US
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Telephone | 928-783-1505
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Fax |
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Provider Business Mailing Address
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Address Line | 3795 W 22ND LN STE 14
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City | YUMA
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State | AZ
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Zip | 85364-9266
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Country | US
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Telephone | 928-783-1505
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. TERESA BENITEZ MOORE
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Credential | MED
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Telephone | 928-783-1505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | BH-4122
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License Number State | AZ
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