Provider Demographics
NPI:1801034996
Name:HILL PUCCIA, ANNETTE THERESA (LPC)
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:THERESA
Last Name:HILL PUCCIA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 E CORAL GABLES DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-3603
Mailing Address - Country:US
Mailing Address - Phone:602-334-5147
Mailing Address - Fax:602-867-0232
Practice Address - Street 1:1 E CORAL GABLES DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85022-3603
Practice Address - Country:US
Practice Address - Phone:602-334-5147
Practice Address - Fax:602-867-0232
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-27
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-13156101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional