Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | LAC-19326 | AZ |
NPI | 1003418856 |
---|---|
Provider Name | Eva Cristina Hidalgo Norheim |
First Address | Tempe, AZ 85281-5576 |
Second Address | Phoenix, AZ 85086-4028 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2020 |
Last Update Date | 16/11/2020 |