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General NPI Number Information
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NPI Number | 1306645627
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Entity Type | Organization
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Legal Business Name | IVAZ LLC
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Dates
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Enumeration Date | 03/10/2025
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 13-1263 LEILANI AVE
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City | PAHOA
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State | HI
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Zip | 96778-8225
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Country | US
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Telephone | 808-315-1918
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Fax | 307-333-0339
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Provider Business Mailing Address
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Address Line | 106 W OSBORN RD STE 1161
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City | PHOENIX
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State | AZ
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Zip | 85013-3909
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Country | US
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Telephone | 808-315-1918
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Fax | 307-333-0339
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Authorized Official
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Title or Position | CHIEF EXECUTIVE MANAGER
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Name | WILLIAM TEMPANY
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Credential |
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Telephone | 808-315-1918
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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