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NPI Code Detail

MEDICARE: MS. BIANCA REAVES

MEDICARE: MS. BIANCA REAVES
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
1225C00000XRehabilitation Counselor
2101YP2500XProfessional CounselorLPC-18511AZ

General Provider Information

NPI Number : 1144523267
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. BIANCA REAVES
Provider Business Mailing Address
First Line : 1001 E PLAYA DEL NORTE DR UNIT 4134
Second Line :
City : TEMPE
State : AZ
Zip : 85281-2198
Country : US
Telephone Number : 702-595-1587
Fax Number : 602-532-7209
Provider Business Practice Location Address
First Line : 4600 E WASHINGTON ST STE 300
Second Line :
City : PHOENIX
State : AZ
Zip : 85034-1908
Country : US
Telephone Number : 702-595-1587
Fax Number : 602-532-7209
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/10/2010
Last Update Date : 04/06/2023

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