Provider Demographics
NPI:1679025936
Name:WOMEN ON THE MOVE, LLC
Entity Type:Organization
Organization Name:WOMEN ON THE MOVE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:SCHRUNK
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:801-376-6298
Mailing Address - Street 1:333 W LEROUX ST UNIT H8
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86303-4265
Mailing Address - Country:US
Mailing Address - Phone:801-376-6298
Mailing Address - Fax:186-643-1878
Practice Address - Street 1:143 N MCCORMICK ST
Practice Address - Street 2:SUITE 103
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301-2723
Practice Address - Country:US
Practice Address - Phone:801-376-6298
Practice Address - Fax:186-643-1878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-02
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-16391251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health