MEDICARE: CHILDREN AND FAMILY COUNSELING OF TUCSON, PC

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	106H00000X	Marriage & Family Therapist	LMFT-10323	AZ

General Provider Information

NPI Number	:	1992121693
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHILDREN AND FAMILY COUNSELING OF TUCSON, PC

Provider Business Mailing Address
First Line	:	6151 E GRANT RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-5802
Country	:	US
Telephone Number	:	520-999-1926
Fax Number	:

Provider Business Practice Location Address
First Line	:	6151 E GRANT RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-5802
Country	:	US
Telephone Number	:	520-999-1926
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	TYLER HOYT
Credential	:	LMFT
Telephone Number	:	520-999-1926

Provider Enumeration Date	:	03/05/2014
Last Update Date	:	03/05/2014

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