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General NPI Number Information
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NPI Number | 1336849801
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Entity Type | Individual
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Provider Name | ELEONORA ANDREICA
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Gender | Female
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Dates
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Enumeration Date | 03/03/2023
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Last Update Date | 08/09/2025
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Provider Practice Location Address
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Address Line | 2715 W NORTHERN AVE
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City | PHOENIX
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State | AZ
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Zip | 85051-6641
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Country | US
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Telephone | 480-256-0104
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Fax | 503-974-2269
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Provider Business Mailing Address
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Address Line | 17830 N 30TH ST
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City | PHOENIX
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State | AZ
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Zip | 85032-1120
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Country | US
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Telephone | 503-939-0308
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Fax |
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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 | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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