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NPI Code Detail

MEDICARE: GINA DREW

MEDICARE: GINA DREW
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 CounselorLPC-10989AZ

General Provider Information

NPI Number : 1598310880
Entity Type Code : Individual
Provider Name (Legal Business Name) : GINA DREW
Provider Business Mailing Address
First Line : 921 W CAMELBACK RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85013-2208
Country : US
Telephone Number : 602-277-4482
Fax Number :
Provider Business Practice Location Address
First Line : 921 W CAMELBACK RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85013-2208
Country : US
Telephone Number : 602-277-4482
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2019
Last Update Date : 08/05/2019

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Directions to “ GINA DREW ” Practice Location

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