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
Fax: (928) 645-8158
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467481168 NPPES
Arizona MEDICAID 972572

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