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General NPI Number Information
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NPI Number | 1548647837
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Entity Type | Individual
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Provider Name | EVA BEATRIX FORNEY
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Gender | Female
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Dates
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Enumeration Date | 05/06/2015
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Last Update Date | 05/06/2015
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Provider Practice Location Address
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Address Line | 5023 W ONYX AVE
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City | GLENDALE
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State | AZ
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Zip | 85302-2426
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Country | US
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Telephone | 623-937-0917
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Fax | 623-937-0917
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Provider Business Mailing Address
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Address Line | 6613 W CORTEZ ST
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City | GLENDALE
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State | AZ
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Zip | 85304-3128
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Country | US
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Telephone | 623-332-1472
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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