Provider Demographics
NPI:1528552452
Name:RICHARDSON, ALICIA
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6424 E GREENWAY PKWY
Mailing Address - Street 2:STE 100
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-0831
Mailing Address - Country:US
Mailing Address - Phone:602-536-7777
Mailing Address - Fax:602-536-8888
Practice Address - Street 1:6424 E GREENWAY PKWY
Practice Address - Street 2:STE 100
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254
Practice Address - Country:US
Practice Address - Phone:602-536-7777
Practice Address - Fax:602-536-8888
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-14
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional