Arizona-Fat, Virginia
Arizona-Fat, Virginia is an individual health care provider with primary practice located at 337 N. Navajo Drive , Page AZ 86040. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Arizona-Fat, Virginia can be contacted via phone (928) 645-6480.Contact Information
Primary practice address
337 N. Navajo Drive
Page AZ 86040
Phone: (928) 645-6480
Fax: (928) 645-8158
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | LISAC-11471 | Arizona |
Profile Details
NPI number | 1467481168 |
---|---|
LBN Legal business name | Arizona-Fat, Virginia |
Credentials | LISAC,CPS |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jul 3rd, 2006 |
Last updated | Aug 19th, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1467481168 | NPPES |
Arizona | MEDICAID | 972572 |
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