Individual
VIVIAN FAJARDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
7865 W BELL RD # 1056, PEORIA, AZ 85382-3803
(602) 825-3925
Mailing address
7865 W BELL RD # 1056, PEORIA, AZ 85382-3803
(602) 825-3925
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LCSW-18599
AZ
1041C0700X
Clinical Social Worker
LCSW-18599
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
082142
—
AZ
Enumeration date
06/15/2020
Last updated
09/30/2024
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