Provider Demographics
NPI:1497289375
Name:GALARZA-HERNANDEZ, AITZA (PHD)
Entity Type:Individual
Prefix:DR
First Name:AITZA
Middle Name:
Last Name:GALARZA-HERNANDEZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7517 QUAIL WOODS RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28411-7273
Mailing Address - Country:US
Mailing Address - Phone:910-431-1773
Mailing Address - Fax:
Practice Address - Street 1:2601 IRON GATE DR STE 101
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28412-6624
Practice Address - Country:US
Practice Address - Phone:910-202-9113
Practice Address - Fax:910-202-9289
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-17
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4754251S00000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No251S00000XAgenciesCommunity/Behavioral Health