Individual
BIANCA CHAVEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8222 S 48TH ST STE 200, PHOENIX, AZ 85044-5303
(623) 300-5477
Mailing address
1324 E STIRRUP LN, SAN TAN VALLEY, AZ 85143-3235
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC-22584
AZ
Other
Enumeration date
04/07/2021
Last updated
12/11/2024
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