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NPI Code Detail

MEDICARE: ANDREA ARISTIZABALA

MEDICARE: ANDREA ARISTIZABALA
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
1101Y00000XCounselorLPC-13219AZ

General Provider Information

NPI Number : 1073913109
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREA ARISTIZABALA
Provider Business Mailing Address
First Line : 3003 N CENTRAL AVE
Second Line : SUITE 200
City : PHOENIX
State : AZ
Zip : 85012-2902
Country : US
Telephone Number : 602-685-6120
Fax Number : 602-265-6973
Provider Business Practice Location Address
First Line : 1802 E THOMAS RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85016-8134
Country : US
Telephone Number : 602-685-6000
Fax Number : 602-258-6280
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2014
Last Update Date : 08/26/2014

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Directions to “ ANDREA ARISTIZABALA ” Practice Location

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