MEDICARE: MS. TINA VOLPE

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
1	385HR2055X	Child Mental Illness Respite Care	439454	AZ

General Provider Information

NPI Number	:	1215110937
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TINA VOLPE

Provider Business Mailing Address
First Line	:	PO BOX 50427
Second Line	:
City	:	PARKS
State	:	AZ
Zip	:	86018-0427
Country	:	US
Telephone Number	:	928-635-1470
Fax Number	:

Provider Business Practice Location Address
First Line	:	15161 N. RABBITBRUSH RD
Second Line	:
City	:	PARKS
State	:	AZ
Zip	:	86018
Country	:	US
Telephone Number	:	928-635-1470
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/17/2007
Last Update Date	:	12/17/2007

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