Provider Demographics
NPI:1730461245
Name:ALDECOA, VANESSA RIVERA (MC, NCC, LPC)
Entity Type:Individual
Prefix:MRS
First Name:VANESSA
Middle Name:RIVERA
Last Name:ALDECOA
Suffix:
Gender:F
Credentials:MC, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1351 W CHAPALA CT
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-4549
Mailing Address - Country:US
Mailing Address - Phone:520-990-3858
Mailing Address - Fax:520-229-6297
Practice Address - Street 1:1351 W CHAPALA CT
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-4549
Practice Address - Country:US
Practice Address - Phone:520-990-3858
Practice Address - Fax:520-229-6297
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-12
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-10632101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional