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NPI Code Detail

MEDICARE: CROZIER RODNEY KIMBALL JR. LPC

MEDICARE: CROZIER RODNEY KIMBALL JR. LPC
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 CounselorCC-0542AZ

General Provider Information

NPI Number : 1063626901
Entity Type Code : Individual
Provider Name (Legal Business Name) : CROZIER RODNEY KIMBALL JR. LPC
Provider Business Mailing Address
First Line : 7459 S RITA LN
Second Line :
City : TEMPE
State : AZ
Zip : 85283-4796
Country : US
Telephone Number : 480-838-7453
Fax Number :
Provider Business Practice Location Address
First Line : 235 S EL DORADO CIR
Second Line :
City : MESA
State : AZ
Zip : 85202-1044
Country : US
Telephone Number : 480-968-2995
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2007
Last Update Date : 07/08/2007

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