Provider Demographics
NPI:1093931263
Name:KRUK, CARLA ARBETMAN (MSW)
Entity Type:Individual
Prefix:MRS
First Name:CARLA
Middle Name:ARBETMAN
Last Name:KRUK
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3716 E DUNLAP AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85028-5042
Mailing Address - Country:US
Mailing Address - Phone:602-953-2977
Mailing Address - Fax:602-953-7075
Practice Address - Street 1:3716 E DUNLAP AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-5042
Practice Address - Country:US
Practice Address - Phone:602-953-2977
Practice Address - Fax:602-953-7075
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW41521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical