Doctor Name: | MR. MICHAEL PANICO |
NPI Number: | 1730516865 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC |
License Number: | LPC-1083 |
Business Practice Address: | 1161 N El Dorado Pl Ste 103 Tucson, AZ - 857154607 |
Business Phone Number: | 5207487108 |
Business Fax Number: | 5205701396 |
Mailing Address: | 1161 N El Dorado Pl Ste 103, TUCSON |
State: | AZ |
Postal Code: | 857154607 |
Phone Number: | 5207487108 |
Fax Number: | 5205701396 |
NPI Enumeration Date: | 10/03/2013 |
NPI Last Update Date: | 10/03/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | LPC-1083 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |