Individual
MRS. VIRGINIA ARIZONA-FAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISAC,CPS
Contact information
Practice address
337 N. NAVAJO DRIVE, PAGE, AZ 86040
(928) 645-6480
(928) 645-8158
Mailing address
PO BOX 2147, KAIBETO, AZ 86053-2147
(928) 673-3267
(928) 673-3269
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LISAC-11471
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
972572
—
AZ
Enumeration date
07/03/2006
Last updated
08/19/2019
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