Organization
HEART SONG WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KARYN A MACKENZIE FAJARDO LCSW (OWNER)
(425) 233-1732
Entity
Organization
Contact information
Practice address
8715 W UNION HILLS DR STE 111, PEORIA, AZ 85382-3031
(425) 233-1732
(623) 248-7737
Mailing address
8715 W UNION HILLS DR STE 111, PEORIA, AZ 85382-3031
(425) 233-1732
(623) 248-7737
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1073171153
NPI
—
01
—
1154445062
NPI
—
Enumeration date
06/03/2019
Last updated
03/07/2022
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