Individual
MRS. TANYA LEA FUENTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MC, LAC
Contact information
Practice address
201 E SENECA DR, BENSON, AZ 85602-6831
(520) 200-7157
Mailing address
100 S 7TH ST STE 2, SIERRA VISTA, AZ 85635-2509
(520) 200-7157
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LAC-08180T
AZ
Other
Enumeration date
07/30/2024
Last updated
07/30/2024
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