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NPI Code Detail

MEDICARE: TRUDY M CRAIG LIAC

MEDICARE: TRUDY M CRAIG LIAC
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
1101YA0400XAddiction (Substance Use Disorder) Counselor155377AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1155377OTHERAZLIAC

General Provider Information

NPI Number : 1730970054
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRUDY M CRAIG LIAC
Provider Business Mailing Address
First Line : 645 W ASH RIDGE DR
Second Line :
City : GREEN VALLEY
State : AZ
Zip : 85614-5493
Country : US
Telephone Number : 520-440-5129
Fax Number :
Provider Business Practice Location Address
First Line : 502 W 29TH ST
Second Line :
City : TUCSON
State : AZ
Zip : 85713-3394
Country : US
Telephone Number : 520-884-9920
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2025
Last Update Date : 01/26/2026

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Directions to “ TRUDY M CRAIG LIAC” Practice Location

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