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General NPI Number Information
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NPI Number | 1760548622
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Entity Type | Organization
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Legal Business Name | ARIZONA FAMILY THERAPY CLINIC INC
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Dates
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Enumeration Date | 12/28/2006
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Last Update Date | 10/28/2012
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Provider Practice Location Address
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Address Line | 1661 N SWAN RD SUITE 244
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City | TUCSON
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State | AZ
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Zip | 85712-4042
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Country | US
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Telephone | 520-327-5522
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Fax | 520-327-5525
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Provider Business Mailing Address
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Address Line | PO BOX 64002
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City | TUCSON
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State | AZ
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Zip | 85728-4002
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Country | US
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Telephone | 520-327-5522
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Fax | 520-327-5525
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Authorized Official
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Title or Position | CLINICAL DIRECTOR CO OWNER
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Name | MS. ELIZABETH R LEINWEBER
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Credential | LCSW BCD
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Telephone | 520-327-5522
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State | AZ
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