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General NPI Number Information
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NPI Number | 1932788791
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Entity Type | Individual
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Provider Name | BIANCA CHAVEZ
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Gender | Female
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Dates
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Enumeration Date | 04/07/2021
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Last Update Date | 12/11/2024
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Provider Practice Location Address
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Address Line | 8222 S 48TH ST STE 200
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City | PHOENIX
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State | AZ
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Zip | 85044-5303
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Country | US
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Telephone | 623-300-5477
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Fax |
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Provider Business Mailing Address
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Address Line | 1324 E STIRRUP LN
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City | SAN TAN VALLEY
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State | AZ
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Zip | 85143-3235
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Country | US
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Telephone |
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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 | LPC-22584
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License Number State | AZ
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