Provider Demographics
NPI:1851075527
Name:BARGHAMADI, MOTAHAREH
Entity Type:Individual
Prefix:
First Name:MOTAHAREH
Middle Name:
Last Name:BARGHAMADI
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 1:920 S TERRACE RD UNIT 1021
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-3805
Mailing Address - Country:US
Mailing Address - Phone:331-465-9789
Mailing Address - Fax:
Practice Address - Street 1:8985 E BELL RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-1573
Practice Address - Country:US
Practice Address - Phone:331-465-9789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-13
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-7907T101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health