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General NPI Number Information
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NPI Number | 1528818887
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Entity Type | Organization
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Legal Business Name | EMPOWERED HEALING THERAPY
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Dates
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Enumeration Date | 03/26/2024
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Last Update Date | 03/26/2024
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Provider Practice Location Address
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Address Line | 18486 S BELLFLOWER PL
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City | GREEN VALLEY
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State | AZ
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Zip | 85614-5599
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Country | US
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Telephone | 520-891-3188
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Fax |
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Provider Business Mailing Address
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Address Line | 815 W VIA RANCHO SAHUARITA UNIT 205
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City | SAHUARITA
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State | AZ
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Zip | 85629-1108
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Country | US
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Telephone | 520-261-1345
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | LISETT MARQUEZ
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Credential | LCSW
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Telephone | 520-261-1345
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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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