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General NPI Number Information
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NPI Number | 1174266779
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Entity Type | Organization
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Legal Business Name | ASYLUM ADVOCATES
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Dates
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Enumeration Date | 04/20/2022
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Last Update Date | 04/20/2022
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Provider Practice Location Address
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Address Line | 4700 S MILL AVE STE 5
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City | TEMPE
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State | AZ
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Zip | 85282-6736
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Country | US
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Telephone | 602-688-9148
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Fax |
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Provider Business Mailing Address
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Address Line | 5222 S 5TH ST
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City | PHOENIX
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State | AZ
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Zip | 85040-8708
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Country | US
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Telephone | 602-688-9148
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. KARA JEAN BREI
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Credential | NCC
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Telephone | 602-688-9148
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101200000X
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Taxonomy Name | Drama Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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