MEDICARE: SARINA BEGAY OTERO

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	101YP2500X	Professional Counselor	LCSW11850	AZ

General Provider Information

NPI Number	:	1336631951
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARINA BEGAY OTERO

Provider Business Mailing Address
First Line	:	10240 N 31ST AVE STE 122
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85051-9564
Country	:	US
Telephone Number	:	602-863-1862
Fax Number	:	602-863-4388

Provider Business Practice Location Address
First Line	:	10240 N 31ST AVE STE 122
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85051-9564
Country	:	US
Telephone Number	:	602-863-1862
Fax Number	:	602-863-4388

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

Provider Enumeration Date	:	05/30/2018
Last Update Date	:	05/30/2018

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Directions to “ SARINA BEGAY OTERO ” Practice Location

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