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NPI Code Detail

MEDICARE: AMBER ANA GRULLER

MEDICARE: AMBER ANA GRULLER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor

General Provider Information

NPI Number : 1033867387
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMBER ANA GRULLER
Provider Business Mailing Address
First Line : 3673 E BAKER PL
Second Line :
City : TUCSON
State : AZ
Zip : 85716-5014
Country : US
Telephone Number : 520-808-8780
Fax Number :
Provider Business Practice Location Address
First Line : 145 E UNIVERSITY BLVD
Second Line :
City : TUCSON
State : AZ
Zip : 85705-7738
Country : US
Telephone Number : 520-808-8780
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/15/2022
Last Update Date : 03/15/2022

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Directions to “ AMBER ANA GRULLER ” Practice Location

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