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General NPI Number Information
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NPI Number | 1932466356
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Entity Type | Organization
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Legal Business Name | TEEN OUTREACH PREGNANCY SERVICES
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Dates
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Enumeration Date | 04/23/2012
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Last Update Date | 04/23/2012
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Provider Practice Location Address
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Address Line | 3024 E FT LOWELL RD
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City | TUCSON
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State | AZ
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Zip | 85716-1572
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Country | US
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Telephone | 520-888-2881
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Fax | 520-770-0035
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Provider Business Mailing Address
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Address Line | 3024 E FT LOWELL RD
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City | TUCSON
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State | AZ
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Zip | 85716-1572
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Country | US
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Telephone | 520-888-2881
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Fax | 520-770-0035
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. LAURA ANN PEDERSEN
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Credential | RN
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Telephone | 520-888-2881
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number | RN000099129
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License Number State | AZ
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