Organization Name: | TIDES OF CHANGE |
NPI Number: | 1811273568 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARIANNE S VALLADARES (CEO/PARTNER) |
Mailing Address: | 333 W Wilcox Dr Ste. 303 Sierra Vista |
State: | AZ US |
Postal Code: | 856351789 |
Phone Number: | 5204582250 |
Fax Number: | 5204582269 |
NPI Enumeration Date: | 10/26/2011 |
NPI Last Update Date: | 10/26/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | LPC12687 |
Healthcare Provider Taxonomy: (Secondary) | N |
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 |