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General NPI Number Information
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NPI Number | 1477028314
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Entity Type | Organization
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Legal Business Name | NORTHERN ARIZONA UNIVERSITY
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Dates
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Enumeration Date | 10/08/2018
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Last Update Date | 10/08/2018
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Provider Practice Location Address
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Address Line | BUILDING 47 A SOUTH SAN FRANCISCO ST
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City | FLAGSTAFF
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State | AZ
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Zip | 86011-0001
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Country | US
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Telephone | 928-523-2119
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Fax | 928-523-2210
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Provider Business Mailing Address
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Address Line | PO BOX 15026
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City | FLAGSTAFF
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State | AZ
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Zip | 86011-0541
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Country | US
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Telephone | 928-523-2119
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Fax | 928-523-2210
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Authorized Official
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Title or Position | ASSISTANT DIRECTOR
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Name | JILL SHERMAN PLEASANT
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Credential |
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Telephone | 602-728-9532
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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