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General NPI Number Information
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NPI Number | 1316858467
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Entity Type | Individual
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Provider Name | MICHAEL BREGMAN LIAC
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Gender | Female
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Dates
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Enumeration Date | 09/16/2026
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Last Update Date | 09/16/2026
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Provider Practice Location Address
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Address Line | 1111 S STAPLEY DR
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City | MESA
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State | AZ
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Zip | 85204-5059
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Country | US
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Telephone | 602-952-3436
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Fax | 480-834-5703
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Provider Business Mailing Address
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Address Line | 1111 S STAPLEY DR
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City | MESA
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State | AZ
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Zip | 85204-5059
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Country | US
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Telephone | 602-685-6000
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Fax | 480-834-5703
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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 | LIAC-155432
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License Number State | AZ
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