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General NPI Number Information
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NPI Number | 1841277969
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Entity Type | Organization
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Legal Business Name | CORAZON INC.
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Dates
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Enumeration Date | 12/29/2005
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 900 E FLORENCE BLVD STE G
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City | CASA GRANDE
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State | AZ
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Zip | 85122-4673
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Country | US
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Telephone | 520-836-4278
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Fax | 520-836-1786
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Provider Business Mailing Address
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Address Line | 900 E. FLORENCE BLVD. STE G.
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City | CASA GRANDE
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State | AZ
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Zip | 85122-4666
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Country | US
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Telephone | 520-836-4278
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Fax | 520-836-1786
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Authorized Official
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Title or Position | CEO/CLINICAL DIRECTOR
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Name | MRS. LETICIA MARTINEZ
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Credential | LPC
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Telephone | 520-836-4278
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | BH2129
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License Number State | AZ
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