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General NPI Number Information
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NPI Number | 1508378266
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Entity Type | Organization
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Legal Business Name | ANGELIKA C BABCOCK
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Dates
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Enumeration Date | 11/02/2017
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Last Update Date | 11/02/2017
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Provider Practice Location Address
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Address Line | 500 E FRY BLVD
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City | SIERRA VISTA
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State | AZ
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Zip | 85635-1839
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Country | US
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Telephone | 254-223-0503
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Fax | 520-335-6585
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Provider Business Mailing Address
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Address Line | 3781 E HOLLY PL
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City | SIERRA VISTA
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State | AZ
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Zip | 85650-5301
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Country | US
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Telephone | 254-223-0503
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Fax | 520-335-6585
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Authorized Official
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Title or Position | THERAPIST
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Name | ANGELIKA CHRISTINE BABCOCK
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Credential | LPC
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Telephone | 254-223-0503
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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 | LPC-16028
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License Number State | AZ
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