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General NPI Number Information
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NPI Number | 1891567541
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Entity Type | Individual
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Provider Name | MITZY RANGEL ZARAGOZA
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Gender | Female
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Dates
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Enumeration Date | 10/26/2023
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Last Update Date | 10/26/2023
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Provider Practice Location Address
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Address Line | 200 W BELL RD SUITE E-102
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City | GLENDALE
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State | AZ
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Zip | 85308
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Country | US
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Telephone | 623-934-9191
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Fax |
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Provider Business Mailing Address
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Address Line | 17600 N 79TH AVE APT 1004
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City | GLENDALE
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State | AZ
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Zip | 85308-8688
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Country | US
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Telephone | 928-503-9944
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | LAC-22477
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License Number State | AZ
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