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General NPI Number Information
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NPI Number | 1386551935
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Entity Type | Individual
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Provider Name | RAVEN V TAYLOR-ADUWAK
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Gender | Female
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Dates
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Enumeration Date | 08/27/2026
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Last Update Date | 08/27/2026
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Provider Practice Location Address
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Address Line | 340 E PALM LN STE 255
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City | PHOENIX
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State | AZ
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Zip | 85004-4604
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Country | US
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Telephone | 602-918-3664
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Fax |
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Provider Business Mailing Address
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Address Line | 656 N 110TH DR
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City | AVONDALE
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State | AZ
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Zip | 85323-6717
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Country | US
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Telephone | 708-980-6894
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | LAC22766
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License Number State | AZ
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