Individual
NICOLE LAZORWITZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
300 W CLARENDON AVE, SUITE 470, PHOENIX, AZ 85013-3420
(520) 428-4528
Mailing address
PO BOX 45396, PHOENIX, AZ 85064-5396
(520) 428-4528
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
4011
AZ
103TA0400X
Addiction (Substance Use Disorder) Psychologist
4011
AZ
103TC0700X
Clinical Psychologist
4011
AZ
103TC1900X
Counseling Psychologist
4011
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
96097
BCBS AUXILARY
NE
Enumeration date
09/16/2006
Last updated
08/07/2014
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