Provider Demographics
NPI:1477239762
Name:BURRUEL, MARIA LUISA GUADALUPE (MS, LPC)
Entity Type:Individual
Prefix:
First Name:MARIA LUISA
Middle Name:GUADALUPE
Last Name:BURRUEL
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1911 S AMALIA AVE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85713-3820
Mailing Address - Country:US
Mailing Address - Phone:520-286-7125
Mailing Address - Fax:
Practice Address - Street 1:1200 N COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-3625
Practice Address - Country:US
Practice Address - Phone:877-634-7333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-22
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-21320101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional