=====================================================
General NPI Number Information
=====================================================
NPI Number | 1265300636
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | EMILIA MUNOZ
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/28/2025
-----------------------------------------------------
Last Update Date | 10/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 281 W 24TH ST STE 135
-----------------------------------------------------
City | YUMA
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85364-8587
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 928-750-5190
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1213 E B ST
-----------------------------------------------------
City | SAN LUIS
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85336-3668
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 928-919-1155
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------