Provider Demographics
NPI:1255847026
Name:PAZ, SANDRA ANITA (LMSW)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:ANITA
Last Name:PAZ
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5954 S JAKEMP TRL
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85747-6003
Mailing Address - Country:US
Mailing Address - Phone:520-272-6265
Mailing Address - Fax:
Practice Address - Street 1:5954 S JAKEMP TRL
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85747-6003
Practice Address - Country:US
Practice Address - Phone:520-272-6265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-15
Last Update Date:2017-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty