Doctor Name: | KATHY RADINA |
NPI Number: | 1992799068 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.ED. |
License Number: | LPC-1404 |
Business Practice Address: | 11 Sundial Circle #2 Carefree, AZ - 85377 |
Business Phone Number: | 4804886096 |
Business Fax Number: | |
Mailing Address: | Po Box 4410, CAVE CREEK |
State: | AZ |
Postal Code: | 853274410 |
Phone Number: | 4804886096 |
Fax Number: | |
NPI Enumeration Date: | 09/06/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | LPC-1404 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |